Commons Chamber

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House Of Commons

Friday 5 May 2000

The House met at half-past Nine o'clock

Prayers

[MADAM SPEAKER in the Chair]

Carers And Disabled Children Bill

Not amended in the Standing Committee, considered.

New Clause 3

Assessments: Parents Of Disabled Children

'(1) If a person with parental responsibility for a disabled child—

(a) provides or intends to provide a substantial amount of care on a regular basis for the child; and

(b) asks a local authority to carry out an assessment of his ability to provide and to continue to provide care for the child,

the local authority must carry out such an assessment if it is satisfied that the child and his family are persons for whom it may provide or arrange for the provision of services under section 17 of the Children Act 1989 ("the 1989 Act").

(2) For the purposes of such an assessment, the local authority may take into account, so far as it considers it to be material, an assessment under section 1(2) of the Carers (Recognition and Services) Act 1995.

(3) The Secretary of State (or, in relation to Wales, the National Assembly for Wales) may give directions as to the manner in which an assessment under subsection (1) is to be carried out or the form it is to take.

(4) Subject to any such directions, it is to be carried out in such manner, and is to take such form, as the local authority considers appropriate.

(5) The local authority must take the assessment into account when deciding what, if any, services to provide under section 17 of the 1989 Act.

(6) Terms used in this section have the same meanings as in Part III of the 1989 Act.'.— [Mr. Hutton.]

Brought up, and read the First time.

9.34 am

I beg to move, That the clause be read a Second time.

With this it will be convenient to discuss the following amendments: No. 29, in clause 4, page 2, line 42, leave out '(1)' and insert '(2)'.

No. 30, in page 2, line 43, leave out '(1A)' and insert '(2A)'.

No. 31, in page 2, line 43, leave out 'such an assessment' and insert—

'an assessment under subsection (1) or (2)'.

No. 32, in page 3, line 1, after '1', insert—

'or (Assessments: parents of disabled children)'.

No. 41, in clause 6, page 3, line 44, leave out 'parent of' and insert—

'person with parental responsibility for'.

No. 22, in page 3, line 44, after 'parent', insert—

', grandparent, step parent or foster parent'.

No. 44, in page 4, line 24, leave out 'parent of' and insert—

'person with parental responsibility for'.

No. 25, in page 4, line 24, after 'parent', insert—

', grandparent, step parent or foster parent'.

No. 45, in page 4, line 26, leave out 'parent' and insert 'person with parental responsibility'.

No. 46, in page 4, line 27, leave out first 'parent' and insert 'person with parental responsibility'.

No. 47, in page 4, line 27, leave out 'the parent may' and insert 'that person may'.

No. 35, in clause 10, page 5, line 20, after '(1), insert—

'Except as provided in section (Assessments: parents of disabled children)(6),'.

I am grateful to have caught your eye, Madam Speaker. Perhaps it might be helpful to explain why I, and not my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry), have moved the new clause. My hon. Friend has been poorly recently. I am happy to take some of the burden off him. My right hon. Friend the Secretary of State for Health supports the proposal too.

On Second Reading, my hon. Friend the Member for Halesowen and Rowley Regis (Mrs. Heal) and the hon. Members for Poole (Mr. Syms) and for Sutton and Cheam (Mr. Burstow) all raised genuine concerns that persons with parental responsibility for a disabled child would be excluded from having an assessment under the Bill. Although support for that group of carers under the Children Act 1989 has been available for some time, and the Carers (Recognition and Services) Act 1995 has already given such carers a right to ask for an assessment of their ability to provide and to continue to provide care for their disabled child, reports from the social services inspectorate and from other sources have shown that they are often poorly served under the existing arrangements. Those points were made eloquently both on Second Reading and in Committee.

Experience of the Children Act indicates that there are problems not with the legislation itself, but, rather, with the implementation of that important landmark legislation. Therefore, during the Standing Committee, I made a commitment to look at how we might give that important group of carers a right to ask for an assessment under the Bill, which would be linked to the delivery of services under the Children Act.

The Government's objective in developing the national carers strategy and, in particular, in supporting the Bill, is to listen to what carers say they want, so that they feel cared for themselves, and can see that their needs are being understood and that progress is being made in ensuring that those needs are met. Parent carers in particular have asked me to ensure that, through the Bill, it is made explicit that the needs of persons with parental responsibility for disabled children must be supported to the same extent as the needs of any other carer who provides, or intends to provide, a substantial amount of care regularly for a person who is aged 18 or over.

New clause 3 underlines the existing arrangements whereby councils are empowered under the Children Act to provide a wide range of services to disabled children and their families. Those services include advice, guidance, counselling, occupational, social, cultural or recreational activities, home help and attendances at a family centre. The Government have listened to the concerns that have been expressed and, with my hon. Friend the Member for Stalybridge and Hyde, have taken action to strengthen the Bill in that important area. The new clause makes it clear that persons with parental responsibility for disabled children will have a right to ask for an assessment under the Bill. For those carers, services will continue to be provided under the Children Act to safeguard and to promote the welfare of those children.

Amendments Nos. 29, 30, 31 and 32 expand clause 4, so that, for the purpose of the community care assessment and an assessment of a disabled child under the 1995 Act, a local council may take into account, so far as it considers it to be material, an assessment under the new clause.

Amendment No. 35 meets the need for a minor technical consequential amendment to clause 10. It takes account of the fact that the definition of "local authority" is different in the National Health Service and Community Care Act 1990 and in the Children Act. Some amendments are technical and often do not look as if they make any sense. I assure my hon. Friends and the House as a whole that amendment No. 35 does make sense. It is purely technical. I hope that the House will support it, and, therefore, the new clause.

Before my hon. Friend finishes his speech, can he tell us what implications the measure has for the costs for local authorities?

I do not think that the new clause will add to the responsibilities of local authorities. It declares on the face of the Bill the existing provisions. These are services that local authorities are already able to provide for parent carers under the 1989 and 1995 Acts. Perhaps I did not make the point clear enough, and we need to look at the origins of the argument.

On Second Reading, the reasonable concerns of, for example, organisations that represent parent carers were aired. They felt that, inadvertently, we were excluding parent carers from the Bill. Consequently, they felt that a signal was being sent that we did not value the importance of their contribution and the role that they play—but nothing could be further from the truth. I know that my hon. Friend the Member for Stalybridge and Hyde in particular feels strongly that the role of parent carers is very important.

A significant part of the national carers strategy itself is to ensure that the Government, working with our partners and local authorities, provide a better range of services to meet the needs of young carers and disabled children and parent carers. That is precisely what the legislation is about. New clause 3 is therefore essentially a declaratory amendment. It will not add anything to local authorities' range of responsibilities, but will make it clear that, under the Bill's provisions, a parent carer could seek the assessment that I mentioned. I hope that my hon. Friend the Member for Denton and Reddish (Mr. Bennett) is clear on that point.

I shall now speak to amendments Nos. 41, 44, 45, 46 and 47. The Bill provides for direct payments and vouchers to parents of disabled children, but not to others who might have parental responsibility for disabled children, such as grandparents. I know that my hon. Friend the Member for Harrow, West (Mr. Thomas) has a particular interest in the subject and has tabled his own amendments, which we may discuss shortly.

This group of amendments will ensure that the advantages of direct payments and vouchers—which my hon. Friend the Member for Stalybridge and Hyde is introducing as an innovation in the Bill—are available not only to parents, but to all those who have parental responsibility. The amendments are necessary to ensure that the new rights of parent carers are more widely available.

The Bill, by including everyone with parental responsibility, will encompass people in whose favour a residence order, for example, has been granted in respect of a child. A residence order automatically confers parental responsibility. Therefore, when step-parents or grandparents or other members of the family have parental responsibility for a disabled child, they will in future also have rights to direct payments and vouchers. It would make no sense at all—and there would be no justification for it—to exclude those people from the scope of the innovatory provisions.

The amendments will make the Bill more consistent with the policy, guidance and practice guide on the Carers (Recognition and Services) Act 1995. A note in the policy guidance states that the word "carer" in the 1995 Act is used

to include parents and others with parental responsibility who care for disabled children.

We are simply making the legislation more consistent.

The intention behind the amendments is therefore to make it clear in the Bill that all those who have parental responsibility for disabled children will have access to the benefits of the new legislation. I hope that hon. Members will be able to support new clause 3 and amendments Nos. 29, 30, 31, 32, 41, 44, 45, 46 and 47.

I shall speak to my amendments Nos. 22 and 25.

I am grateful for the opportunity to speak in this debate. My hon. Friend the Member for Lewisham, West (Mr. Dowd) inspired me to seek to speak on Second Reading, but I was not so fortunate as to catch the eye of the occupant of the Chair. I am therefore particularly pleased to be able today to support my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry), with whom I have worked on various issues in his promotion of the Carers and Disabled Children Bill.

My two amendments are probing amendments, to flag up the rights of those who take over parental responsibility but are not the child's parents. As we all know, there are occasions when, for whatever reason, a child's parent is no longer that child's guardian.

Clause 6(1) will insert two new sections—17A and 17B—into the Children Act 1989, and it is worth recapping what the new sections will do. According to the Bill's explanatory notes, new section 17A

enables a local authority, instead of providing services for a disabled child under the Children Act, to make to the parent carer a direct payment in lieu of those services to enable the parent carer to arrange for provision of those services rather than rely on direct service provision from the local authorities.

9.45 am

New section 17B will

enable the Secretary of State or, as the case may be, the National Assembly for Wales, to make provision in regulations for the issue of vouchers by local authorities to parent carers to enable the parent carer to arrange for someone to care for their disabled child while they take a short break from their caring responsibilities.

My amendments extend those opportunities to a grandparent, step-parent or foster parent.

In Committee, my hon. Friend the Member for Stalybridge and Hyde said:

I am aware that parents like to have as much freedom as possible when making arrangements for the care of their disabled children. The clause will give them far greater choice.

He is absolutely right about the effect of clause 6. My amendments seek merely to extend that freedom to grandparents, step-parents and foster parents.

My hon. Friend went on to say:

Direct payments will be particularly helpful to young disabled people leaving home—for example, to enter further or higher education, or perhaps to enjoy a more independent life.—[Official Report, Standing Committee C, 15 March 2000; c. 54.]

My hon. Friend is absolutely right about that, too. My amendments simply extend the same opportunities available to parents with responsibility for care to grandparents, step-parents and foster parents with responsibility for care.

The Carers National Association has provided a very useful briefing for today's debate. On clause 6, on vouchers for breaks, it states:

The principle of vouchers is similar to direct payments as it gives control to disabled people and carers, giving them, rather than officials, the freedom to choose where and when to take a break. Vouchers effectively "cut out the middle-man".

In my two amendments, and in other probing amendments, we want to ensure that the freedoms provided in the Bill for parents are extended to grandparents, step-parents and foster parents. My hon. Friend the Minister has made some made positive comments, which show that the Government are already dealing with those concerns.

I commiserate with the hon. Member for Stalybridge and Hyde (Mr. Pendry). It is always sad when one reaches the final stage of the drama to find that one of the main protagonists is indisposed. Nevertheless, we needed to hear the Minister's comments on this important new clause and group of amendments.

New clause 3 is absolutely key, addressing an issue that was raised quickly by all those who spoke on Second Reading. Hon. Members on both sides of the House were concerned about the danger that, quite inadvertently, the legislation as originally drafted would disadvantage parent carers. However, on 8 March, the Minister gave us the assurance that a declaratory amendment would be tabled for today's debate, making explicit parent carers' right to assessment. For that reason, we particularly welcome these corrections. Conservatives are never interested in the proliferation of legislation for its own sake, but we can safely say that the new clause will close a loophole and it will be in everybody's interests—the parent carers, the cared-for person and the state—to ensure that that group of carers is not disadvantaged.

I have a couple of slight concerns about the remaining inconsistencies. I am pleased that the new clause puts more pressure on local authorities to carry out assessments by the use of the word "must", but that is an interesting change of style and tone from other aspects of the Bill, where the word "may" is more often used. In Committee, the Minister assured us that "may" means "will", but we have the word "must" here. For the sake of consistency, we should get our definitions right.

The hon. Lady has misquoted me. When I said that "may" could be interpreted as "will" I was talking about the Secretary of State's intention to use his powers to issue regulations or guidance. I did not mean that "may" meant "will" in the context of carrying out an assessment, because that would not be consistent.

I thank the Minister for that clarification. I shall need to look back at the exact wording of Hansard, but he certainly got my point in Committee. We have all seen examples of the word "may" turning out in practice to be a bit weak. Amendments Nos. 4, 7 and 24, which we shall debate later, would strengthen the Bill by changing "may" to "shall". I am sure that hon Members understand my point about the inconsistencies that can occur with the use of apparently simple little words. However, we welcome that important change.

The amendments cover two different categories, but the point about the need to widen the definition of a parent carer is well taken. I am sure that none of us wishes to see someone who takes on the enormous parental responsibility for a disabled child excluded from the opportunities that should be available to deserving carers. The hon. Member for Harrow, West (Mr. Thomas) made that point, although I could not resist a slight smile about his new-found enthusiasm for voucher systems. I am sure that there have been long and substantial debates in this place about voucher systems in the past. It is interesting to hear Labour Members being newly positive about their virtues.

Parent carers are a special category, because they most directly bear the responsibility for being on point for a disabled child. Yet as they and the Carers National Association have made plain, they have sometimes found themselves inadvertently disadvantaged under existing legislation—which tends to be child-focused—although they are the last group to complain. There is sound logic in tidying up the issue and ensuring that a deserving group of carers is not inadvertently disadvantaged.

I looked at the new clause with a sense of déjà vu, because at one time in my past I spent a lot of time dealing with assessment, albeit in a different context—I refer to the special educational needs code of practice under an altogether different Bill. Underlying the wording of the new clause are some potential difficulties. I have a few questions for the Minister, as the new clause is in his name as well as that of the hon. Member for Stalybridge and Hyde (Mr. Pendry). I join other hon. Members in expressing my sympathy for the hon. Gentleman, who is the sponsor of the Bill. He has bravely managed to be here today, but on this occasion—although I would normally deprecate the practice—we accept that the Minister may well bear much of the brunt of replying, for reasons that we all understand.

The new clause perhaps inevitably uses terms with a wide range of possible interpretations, such as

a substantial amount of care

and

an assessment of his ability.

This is well-worn territory, but every time we seek to extend the scope of legislation, we inevitably raise questions about whether the inevitable bureaucracy will be able properly to support the aim of that legislation. My first simple question for the Minister is whether he is satisfied that the use of such words is tight enough and whether sufficient guidance is given to ensure that a key phrase such as

a substantial amount of care

will be properly interpreted and put into effect.

That problem is even greater in respect of subsection (1)(b). The phrase

carry out an assessment of his ability to provide and to continue to provide care for the child

raises various questions about the meaning of the word "ability". I thought that the Carers (Recognition and Services) Act 1995, which is referred to in the new clause, might give greater guidance. However, I have to disappoint you, Mr. Deputy Speaker, as well as myself and some others, by saying that it does not. It simply uses the same form of words.

We have to ask whether the term "ability to provide" is sufficiently well understood or easily interpreted to eliminate any doubt. Some of the issues are covered by later amendments, so I do not want to dwell on them unduly, but as well as referring literally to the skills necessary, that phrase could also cover areas of character, which might more appropriately be regarded as suitability. I should like guidance from the Minister on whether that is the intention.

I accept the right hon. Gentleman's point about phrases such as "a substantial amount" and their interpretation not just by us, but by carers. Does he agree that the answers for our constituents and for carers might be found in the regulations referred to in clause 10 rather than in the Bill, which does not go into such details of interpretation?

I fully accept what the hon. Gentleman says. This is familiar territory to all of us. How far is it reasonable, proper or even profitable to expect such detail in a Bill and how far should we look to regulations? I am looking for reassurances that the Minister is satisfied that we have sufficient guidance in the Bill to enable us to be confident that the regulations that will flow from it will provide answers. That is all that we can reasonably expect at this stage.

My final point is about finance. The Minister will delighted to know that I have a copy of the Children Act 1989 with me; I am sure that he, too, has a copy. Clause 17 of that Act explicitly refers to finance. We shall have an interesting debate later on amendments, one of which I tabled, to try to elucidate matters. However, in the context of new clause 3, I simply inquire whether "ability" encompasses financial capability. Skills, character and finance are potential aspects of "ability". That raises important questions, which may affect the regulations that would underpin new clause 3. They are vital to a full understanding by carers, authorities and all those who will be involved in interpreting the Bill. Clarification and interpretation are therefore necessary.

10 am

I tabled an amendment, which was not selected, to try to clarify the new clause's provisions on appeals. In the special educational needs code, we were careful to make proper provision for appeals in cases when a bureaucracy makes an assessment. That has become increasingly commonplace. Some would argue that it was self-evident that erecting a second bureaucracy to second-guess a first was counter-productive and costly. However, nowadays, we rightly want to pay more attention to the rights of individuals, who are often vulnerable against a bureaucracy. In cases of doubt, we should tip the balance in favour of individuals.

if the House accepts that, we should be able properly to identify a mechanism whereby someone who has undergone an assessment process such as that which the clause outlines, and is dissatisfied with the result, can appeal. Such dissatisfaction often occurred in the educational context because local authorities and their officers were worried about the financial aspects of an assessment process. With more than half an eye to that, local authority officers may take a narrower and more rigorous view of the responsibilities than the sponsors of the Bill or the Minister intended. Against that background, an appeals mechanism becomes even more important.

Is the Minister satisfied that there is sufficient opportunity for individuals to appeal or to come back to the local authority after the assessment process?

I understand the arguments for an appeals procedure, but the assessment process takes time and can be bureaucratic. In pressing for an appeals process, the right hon. Gentleman is in danger of supporting further bureaucracy. Would it not be better to use the local government ombudsman, and the power of local councillors or Members of Parliament to make a fuss?

Those are possibilities. The ombudsman is a splendid institution, but we are all aware of the shortcomings of the ombudsman process. I narrowly interpret the role of Members of Parliament vis-à-vis such processes, although I have a much greater regard for the role of councillors. However, that role is not necessarily adequate to solve the problem; it was not when we considered the educational context. We set up a tribunal process, which has proved its worth. Will the Minister be able to satisfy those who are likely to undergo the assessment process that, if something goes wrong and they feel that they have not had a fair deal, proper recourse is available? I put that in simple terms so that I do not overcomplicate matters. Given that my amendment was not selected, I cannot pursue the subject of tribunals at greater length. However, an important question needs to be tackled.

Our discussion today is valuable because it enables us properly to explore the sort of questions that I raised and, as far as we can, to resolve doubts. After all, that is why we are here. The Minister has an opportunity to explain his views; that will provide guidance about what may happen subsequently at a later stage in the Bill's progress or in preparing regulations.

I hope that the Minister will be able to provide full and proper replies and set my mind at rest that the areas of unhappiness that I identified will be properly resolved.

I welcome new clause 3 and support the proposal to include step-parents, grandparents and foster parents in the provision. My hon. Friend the Minister referred to the anxieties that I and others expressed on Second Reading and in Committee about the fact that parents were not specifically mentioned in the Bill. The omission was not deliberate, but the new clause gives us an opportunity to rectify a clear oversight.

It has already been said that the Children Act 1989 and the Carers (Recognition and Services) Act 1995 provide for services for disabled children. It is right that the needs of disabled children are met specifically by a children's service. In many cases, that service is more than adequate for their needs. However, parents and their needs are increasingly overlooked—we know that through information we have received from the Carers National Association and Contact a Family. Both organisations expressed anxiety about those who undertake considerable responsibilities for their children over a long period. Those of us who are fortunate enough to be the parents of healthy children realise that while responsibilities do not disappear completely as they grow older, they decrease. That is rarely the case for parents of children with disabilities.

Contact a Family has stressed the importance of the fact that many disabled children have complex needs, many have more than one disability and many have severe behavioural problems. Let us stop for a moment and consider what that might mean for the parents, not occasionally, but every day of those children's lives. To highlight that, I shall refer to two examples, one of which concerns a young child. We readily think of young children as being in need of parental care, but we should remember that parents of disabled children, even when the children become adults with disabilities, continue to have responsibilities.

I take the examples from research by Saul Becker and Richard Silburn that was published in June last year. The first example is of the Shah family:

Joy Shah is 9. Her birth was extremely premature, and for some months her continued survival was in doubt. She has cerebral palsy with almost complete loss of mobility. She spends most of her time in a lying position or sitting propped up. She is doubly incontinent. Her sight, hearing and speech are unimpaired, as are her mental faculties, so she is able to attend an integrated school. She is cared for by both her parents, although it is her mother who is the primary carer.

No matter what services are provided for that little girl, although they will obviously help her parents to care for her, they will not necessarily meet her parents' needs. On Second Reading we asked for parents' needs to be assessed, and that is now happening. The Government have listened to their Back Benchers and to organisations working on behalf of carers—all carers, but parent carers in particular.

I shall now refer to someone much older than that little girl: a man of 44.

From an early age his development and behaviour were such that it was suggested he had severe learning difficulties. It was many years later and almost by accident that the more accurate diagnosis of autism was made. Throughout his life he has been cared for by his parents. However his father David suffered a stroke 13 years ago since when his mother Sarah has had to care for both son and husband.

I think it right and just for us to consider carefully the needs of parents who undertake such responsibilities over what is often a very long period.

The new clause allows parent carers to receive the same rights to assessment and services as all other carers. That sense of equality and social justice must run through legislation of this kind. I welcome the change, and the new clause. I also agree with my hon. Friend the Member for Harrow, West (Mr. Thomas) that we should consider the position of step-parents and grandparents. In many instances circumstances change and it is left to people other than the natural parents to care for children.

This is an excellent move by the Government and I welcome the changes.

I shall be brief, but I want to pick up a point made by the right hon. Member for Bromley and Chislehurst (Mr. Forth). We discussed the issues of tribunals and appeals in Committee, partly as a result of an amendment tabled by Opposition Front Benchers. The assessment process leads to a care plan, and we ascertained from the Minister that there would be a separate care plan for the carer. That important distinction also arose from the Carers (Recognition and Services) Act 1995.

Because assessment is a never-ending process—because a cared-for person's needs change, and because a carer's needs may well change, possibly as a consequence of the needs of the cared-for person but also owing to his or her own circumstances—I am not convinced that a tribunal mechanism similar to the one applying to statements about special educational needs is applicable. What is essential is clear documentation: clear statements that can be used to contest the local authority's determination of what it proposes to offer through the care plan. There must be clear procedures for local authorities to operate so that carers can challenge statements in the care plan.

I welcome both the new clause and the amendments, which go a long way towards meeting the concerns raised on Second Reading and in Committee—especially the declaratory amendment which clarifies further the issue of whether parents with caring responsibilities for disabled children is covered.

10.15 am

I thank right hon. and hon. Members, including the right hon. Member for Bromley and Chislehurst (Mr. Forth), for the support that they have expressed for the new clause and amendments. Some hon. Members raised specific points, which I shall try to answer.

The hon. Member for Sutton and Cheam (Mr. Burstow) and my hon. Friend the Member for Halesowen and Rowley Regis (Mrs. Heal) were right to say that we are trying to respond to concerns that were legitimately expressed about the original drafting of the Bill. Neither my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) nor I had any intention of excluding parent carers from the benefits that it provides, because they do a good deal of important work in communities throughout the country. We value and cherish that work and we want to strengthen the support that we give them. We are putting the matter right, and we are putting it beyond any doubt.

The right hon. Member for Bromley and Chislehurst made three points. He expressed concern about what he described as loose wording and drafting in the Bill. In fact, some of the wording that he considered suspect mirrors the terms of the Carers (Recognition and Services) Act 1995, in whose passage the Under-Secretary of State for Education and Employment, my hon. Friend the Member for Croydon, North (Mr. Wicks), played such an important part. I think that, as a former Minister, the right hon. Member for Bromley and Chislehurst will recognise that there is a case for ensuring that subsequent legislation is consistent with the terms of similar legislation, and that is what we are trying to do.

The right hon. Gentleman was particularly concerned about terms such as "suitability" and "ability". We shall be able to use the powers that we have under the Local Authority Social Services Act 1970 to give local authorities guidance about the implementation of the Bill. We have always made clear our intention to use those powers to ensure that authorities implement the Bill in the way that my hon. Friend the Member for Stalybridge and Hyde—and others would wish. There is no risk that things will go wrong in the way that the right hon. Gentleman identified.

Because of the Bill's history and the fact that it builds on earlier Acts, if there had been any evidence that its language would cause serious difficulty in its practical implementation we would probably have known about it by now. As there is no such evidence, we are fairly confident—as, as I am sure, is my hon. Friend—that the legislation is satisfactory in that respect.

The right hon. Gentleman raised another point, which I know he wants to discuss later, so I shall not spend too much time on it now. He was concerned about the extent to which the new clause would enable local authorities to take resources into account when assessing the needs of parent carers. He has a good memory, as all Labour Members know—particularly on Fridays when we debate private Members' Bills. He may wish to be reminded, however, that when he was a Minister the Government of whom he was a member considered these issues in the context of the guidance and advice that they gave to local authorities. The position is clear: according to existing guidance and practice, it is not acceptable for authorities to take resources into account when assessing a person's needs.

The right hon. Gentleman wants something slightly different—we shall discuss that amendment later—but I think the current position is right. It is not appropriate for resources to be taken into account in the assessment of a person's need for support services. Charging may be an issue—we shall discuss that later as well—but when a person's needs are being assessed that person's means are irrelevant and should not be part of the assessment. That would be putting the cart before the horse. We are clear about this, and so were the right hon. Gentleman's Government, who took the same view.

I want to deal with amendments Nos. 22 and 25, tabled by my hon. Friend the Member for Harrow, West (Mr. Thomas). My hon. Friend the Member for Stalybridge and Hyde and I have already tabled amendments to make it clear that the term "parent" means all those with parental responsibility for disabled children. If, for example, a disabled child is being brought up by step-parents or grandparents, the Bill allows them to receive direct payments and to take advantage of the new voucher scheme. The problem with the amendments is that they also refer to foster parents.

Foster parents do not usually have parental responsibility for the children for whom they care. Parental responsibility remains with the parent, or may, as the result of a court order, have been granted to the local authority. When foster carers are looking after disabled children, the local authority has a range of responsibilities under the Children Act 1989 to support those placements.

I hesitate to ask this question because I have not had much experience in this area. However, it occurs to me that foster parents have been deemed to be suitable and appropriate, and the authorities have had to be satisfied as to their role. That might not always be the case with step-parents or grandparents and, therefore, what the Minister says appears to be back to front. Cannot we have greater reliance on the status of foster parents, rather than step-parents or grandparents?

It does not usually stop the right hon. Gentleman asking questions if he does not know anything about the subject matter. I was talking about a specific concept of parental responsibility. It is not always the case that step-parents or grandparents have parental responsibility for a child with whom they happen to live. Parental responsibility is a legal concept, and we have to be clear about it.

Local authorities could arrange respite care for a disabled child to give the child a special holiday or to give the foster family a break, and regular reviews of all children in foster care provide the opportunity for ensuring that the welfare of the child has been promoted and the placement is receiving proper support. Where grandparents and step-parents do not look after disabled children, or indeed if they do but do not have parental responsibility, it is not for them to ask for direct payments or vouchers—it is for the parents who look after the children or child to do so.

The Bill is aimed at those with parental responsibility and at those in greatest need. I hope that my hon. Friend the Member for Harrow, West will agree that we should not extend the provisions of the Bill to other family members, who may have a proper interest in the disabled child but do not have parental responsibility for him or her. I hope that my hon. Friend will withdraw his amendments.

rose—

Order. The hon. Gentleman cannot speak again on this matter. His amendments will stand or fall according to the decisions of the House before they come in the sequence.

Question put and agreed to.

Clause read a Second time, and added to the Bill.

New Clause 2

Carers' Plan

'.—Every local authority shall prepare a Carers' Plan setting out how it proposes to provide services to carers assessed under section 1.'.— [Mr. Gareth R. Thomas.]

Brought up, and read the First time.

I beg to move, That the clause be read a Second time.

With this it will be convenient to discuss the following amendments: No. 10, in clause 2, page 2, line 3, after "decide", insert—

'in consultation with the carer'.

No. 11, in page 2, line 8, leave out "whether or not" and insert "how".

No. 13, page 2, line 12, leave out—

'in the local authority's view'.

No. 14, page 2, line 16, after 'service', insert 'or other assistance'.

Every local authority is already required by law to publish a community care plan, under the National Health Service and Community Care Act 1990. It is supposed to be good practice to include support for carers in that care plan, and local authorities are already under a legal obligation to consult carers on the plan. However, one of the problems with the community care plan documents that are produced by local authorities is that they are large and very general. For many carers, they are inaccessible.

The new clause proposes that every local authority should be under a statutory requirement to prepare a specific carers plan about how it proposes to provide services to carers. There are several clear advantages to that. Carers plans would provide much greater transparency for carers who wish to know more about how local authorities will take forward their new rights under the Bill. They would also allow greater accountability. The majority of local authorities are clear about how policy and practice should be executed in terms of the provision of services for carers, but the experience of the first year of operation of the carers grant demonstrated, according to research by the Carers National Association, that some local authorities do not always follow statutory guidance sufficiently closely.

One in 10 local authorities intended originally to spend less than 25 per cent. of the carers grant on services that provided carers with a break, even when the grant order specified that at least 75 per cent. of the grant moneys had to be spent on carers' breaks. To deal with that problem, this year's grant conditions specify that the local authority has to fill in a pro forma giving its clear intentions for spending the grant, so we are already close to local authorities having to produce a separate carers plan. The Carers National Association believes that the pro forma will help to standardise the information collected on the carers grant and ensure better accountability for carers, who will be able to see whether the new money is being spent on breaks rather than existing services.

A carers plan drawn up in consultation and partnership with carers would offer new weapons to help carers shape the way in which services are delivered to them. It could also help to foster better sharing of good practice. For example, carers plans could be linked to the Department of Health's new carers internet site, at www.carers.gov.uk, which is a welcome innovation.

All English local authorities were required to produce a carers plan in 1999 on how break services for carers would be developed. Social services inspectorate care regions report that most authorities have engaged well with carers and their representative organisations. I understand that the social services inspectorate care regions will follow up with local authorities how they continue to perform against last year's plans. If local authorities produced carers plans last year, there is no reason why they should not be required by the Bill to account to carers and local residents for how they are providing services to carers every year. There is considerable support for the work that carers do and considerable concern about the support they get. The publication of carers plans by local authorities would help to ensure that carers services receive the proper focus that they require from local authorities.

Last year, the Government announced some £20 million in 1999–2000 for the carers special grant. This year some £50 million will be allocated and, for 2001–02, the figure will be some £70 million pounds. If taxpayers' money is to be allocated for additional carers services, a carers plan would help to ensure that the money was properly accounted for. One of the conditions of the carers special grant was that local authorities reviewed, with other agencies, their provision of services to give carers a break from caring. Local authorities were required, in the first year of the grant, to involve and consult carers and their organisations on the appropriateness of existing provision and the possibility of greater diversity. Local authorities are therefore used to preparing carers plans and consulting with carers. I contend that they should be required to do so every year.

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It was expected that where current services met needs last year they would be enhanced by the additional money, and that where more diversity was needed authorities would plan for the provision of further services. A carers plan would help to specify how those new services were being developed. Another key benefit of a carers plan is that it would help to solve a problem that many of us recognise—the lottery in the provision of carers services. Access to certain services is much greater in some local authorities than others, and the requirement to publish a carers plan would increase local authorities' accountability and reduce the sense of there being a lottery in provision.

Carers have a difficult time accessing their rights and receiving information about services. A carers plan would help to solve that problem. Research carried out by the Carers National Association in 1997 found that only 18 per cent. of carers providing substantial amounts of care had received an assessment of their needs. In 1994, the Carers National Association found that only 32 per cent. of carers had received a copy of the disabled persons care plan. In 1997, it found that some 85 per cent. of carers had received feedback since their assessment, but only 56 per cent. had received it in writing. However, more recent research carried out in 1998 found that 72 per cent. of carers had not received a copy of the hospital discharge plan that they needed. All that suggests that implementation of policy in some areas still needs further work and the spotlight provided by a carers plan would help to encourage local authorities further to develop and implement policy laid down by the Department of Health.

The problem of access to services was highlighted by the excellent social services inspectorate report that was published in November 1998, entitled "A Matter of Chance for Carers". It stated in its opening paragraph:

The quality and type of support that carers receive remain a matter of chance. Support depends far more on where carers live and who they are in contact with within social services than what they need. Some carers are offered very sensitive practical and emotional support, but others receive no information about what might be available and they are not assessed.

A carers plan would clearly help to tackle the problem of lack of access to information. A requirement to publish a carers plan would also be a useful tool in Government efforts to reduce the lottery of care and would complement the development of new performance assessment frameworks.

Now that local authorities have to count the number of carers who are being assessed, they are becoming more conscious of offering assessments, ensuring that the right policies are in place and recording the right information. Of course, collecting statistics cannot guarantee that carers are given good assessments, but it is a step in the right direction. The publication of such information in a carers plan would clearly increase the accountability of those who are supposed to be providing services to carers.

A carers plan would also complement the Government's fair access to care initiative, which I understand has not yet been published. The Carers National Association very much hopes that it will further reduce the lottery of care.

The Government's concern about the range of eligibility criteria for services was flagged up as early as the 1997 social services White Paper. Again, a carers plan would help to complement efforts to standardise the eligibility criteria and make them fairer. Authorities tend to draw up eligibility criteria for social services based on the degree of risk to the disabled or elderly person. They use those criteria to determine, for example, whether an elderly woman with particular needs would have access to certain services.

Eligibility criteria also seem to exist for carers who try to exercise their right to assessment. Some carers have been told by social workers, "You're not in crisis yet, so you don't need an assessment." That goes against good practice and against the wording of the Carers (Recognition and Services) Act 1995 introduced by the Under-Secretary of State for Education and Employment, my hon. Friend the Member for Croydon, North (Mr. Wicks), which clearly states that carers have a right to request an assessment if they are providing regular and substantial care. The law does not require them to be in crisis for that to happen. What some carers are being told also goes against the Government's prevention agenda and is clearly against basic common sense.

A carers plan would facilitate the publication of such eligibility criteria and would help to hold local authorities to account. It would also complement efforts to break down the health and social care divide—an issue that concerns many hon. Members. It is a key issue for carers, who feel strongly about it. Research carried out by the Carers National Association in 1998 revealed that the first priority for the vast majority of carers was that health and social services should work closely together. Many respondents mentioned the problems of policy and service fragmentation and said that the need to break down the Berlin wall between health and social services was affecting the care that they were able to access. They commented on the experience of being batted between the NHS and social services. One carer said:

social services should get together with the NHS to provide a joint package instead of arguing with them about who pays.

Clearly a carers plan would help to complement efforts to provide that joint package.

When the NHS and social services fail to agree to provide services, or fail to provide joined-up services, those who suffer are the disabled, the ill or the elderly. Carers are too often left to cope with unacceptable levels of caring responsibility.

My hon. Friend has gone into great detail about the current situation and he obviously believes that the carers plan is a major issue. However, in relation to a previous group of amendments, my hon. Friend the Minister said that the Government were considering strengthening guidelines to local authorities. Which is the best mechanism? Is it a carers plan that goes into great detail, or is it stronger central guidance to local authorities so that we no longer have the situation in which some people are more equal than others when it comes to accessing care from the local authority?

I do not think it is a matter of having one or the other. We need stronger central guidance and a carers plan to throw a spotlight on how local authorities are responding to that guidance.

The challenge of having to produce a carers plan for public consumption would help to identify problems and make sure that the partnership grant, which is part of the modernising social services grant that will be provided by the Department of Health to local authorities in England over the next three years, is properly spent. I understand that the partnership grant is designed to encourage closer and more joined-up working.

We also have legislation to back up the notion of more creative joint working. The Health Act 1999 introduced a new way of closer working whereby there are clear benefits to be gained, including integrated services, pooled budgets and lead commissioning, and local authorities and health authorities can transfer their commissioning responsibility to each other. A carers plan would help to reveal just how successful local authorities and health authorities have been in responding to the Health Act 1999.

The Carers National Association believes that monitoring is extremely important as it is likely that areas that have better joint working relationships are more likely to be able to bid for budget flexibilities. A carers plan would clearly provide an important source of monitoring, which the Carers National Association has identified as particularly important.

The association asked what would happen in areas where there were poor joint working relationships. A carers plan would help to expose those poor relationships, and enable the social services inspectorate to take appropriate action.

As part of my research for this debate, I consulted the Alzheimer's Disease Society. I was told that about 5,000 people with dementia live in the Brent and Harrow health authority area, which means that there are at least two or three times that number of carers. Clearly, a carers plan would be of great benefit to people with dementia.

The society stressed that the amount of informal care provided by friends, volunteers and family is substantial. Two thirds of people with dementia continue to live in their own homes. A significant minority live alone, but most are cared for by family members, many of whom are elderly themselves. The society said that the shift in the 1980s from residential care to community care increased the burden on family carers. By providing more information, a carers plan would help to relieve some of that burden.

The Alzheimer's Disease Society made it clear that a partnership between carers, people with dementia and the staff who work with them is vital to the development of sustainable long-term care. A carers plan would show whether such a partnership was in place. If that partnership were not in place and working properly, a carers plan would help ensure proper accountability to carers and provide information about where they could turn for help.

The society told me that carers need practical support, which may take the form of financial help, respite care, training or information. A carers plan would help identify how much support carers need, and where they could find it. Recent research showed that a carer's ability to cope was the most significant factor in the shift from home care to institutional care, but that inadequate training and support for carers was widespread. A carers plan would help to show where such training and support was available.

The Government recognise the separate needs of carers, but many carers remain unaware of the support available. A carers plan would help them find out where the support that they need can be found. Respite—the provision of a break from caring—is one of the most frequent of carers' requests, as the House will know. It tends to be provided with the explicit aim of avoiding institutional care, so it is ironic that short-stay institutional care remains the most easily accessible form of respite provision for people with severe dementia or behavioural disturbances.

However, that form of respite is sometimes not the most effective or desirable form of support. Flexible, community-based models of respite include family support schemes and sitting services schemes. They extend the range of respite opportunities available and may enable a carer to continue to care for a person with dementia for a longer period.

Such alternatives are needed, and a carers plan would help people to know where those new forms of respite could be found. Some local authorities would be shown to be relatively advanced in the provision of that support compared with their neighbours. That might encourage those neighbouring authorities to increase support provision in their areas. High-quality respite care could also help to reduce levels of abuse and maltreatment of elderly people, according to the Alzheimer's Disease Society.

10.45 am

Carers report that they suffer less stress and anxiety and are better able to cope with their caring role if they have access to good information and support. A carers plan identifying the range of support available to carers could only be of benefit.

The voluntary sector is highly successful in providing information. The better carers are educated, the better they are able to cope with the changing nature of the disease. Carers have said that the early provision of support and training for family members and friends not only improves the quality of care for the person with dementia, but relieves some of the anxieties of carers. Access to the early provision of support and training would be facilitated by the publication of a carers plan.

Early support would also help carers understand their own emotional responses and need for support. It is worth noting that when a person with dementia moves into residential provision, carers often continue to provide care, albeit in a different role. Moreover, many carers continue to share their experiences with others, offering support and advice for many years after their own caring responsibilities have ended. A carers plan would enable former carers with experience of the health and social care system to contribute to discussions about the type of services that carers should be given. Former carers would also help to hold local authorities to account over the support that they give to carers.

Many carers suffer financial hardship, which often compounds their emotional and social problems and can lead to a deterioration in their mental and physical health. Information about the support available to carers through the benefit system could be properly identified in a carers plan, and would therefore be of immense benefit. I hope that the Government's changes and improvements to the benefits system will include increased support for carers. A carers plan would inform carers about those changes.

Carers are often less able to participate in social activities. They provide most of the care given to people with dementia, and it is essential that they are not penalised as a result. Again, access to information about the benefits available from the Department of Social Security and through the tax system would be part of a carers plan.

I have listened to the hon. Gentleman's speech closely, and I agree with much of what he has said about the idea of a carers plan. However, he seems to be describing two very different purposes for the plan: one purpose seems to be to inform carers about their rights and the services available to them, but the second purpose seems to be that it should act as a planning document and a tool for making local authorities—the service providers—more accountable. Does the hon. Gentleman agree that those purposes do not fit well together?

I do not agree. I believe that the two purposes fit well together. A carers plan would be an opportunity to provide information to carers and, by highlighting what was available for them, it would be a useful document in terms of holding local authorities accountable. In addition, a carers plan would help to inform the planning and delivery of services.

Carers also tend to forgo employment opportunities. As a result, they are often unable to contribute to pension schemes, and they can find it harder to return to employment when their caring role has ended. Information about returning to employment could be included in the plan.

Information for carers would be one of the most profound benefits of a carers plan. I have already flagged up the Department of Health's excellent carers website, which was launched on 8 February. That will provide Departments with the opportunity to put on the internet details of the services and benefits affecting carers that they provide. I think that carers plans, particularly those of the highest quality, should be linked in to such a website, making it easier for carers who have access to the internet to get information about what services the Government are providing.

Carers plans must properly reflect the needs of black and ethnic minority carers. I understand that the Department of Health has forged strong links with national and London black carers forums. I contend that carers plans would enable local authorities properly to identify what support they are providing to those groups of carers.

In the course of my preparation, I consulted the Parkinson's Disease Society. People caring for someone with Parkinson's disease might want specific information in a carers plan, such as where specialist clinics are available in the health service. They might want to see evidence of work by the local authority and the health authority that shows that efforts are being made to increase awareness of the disease among other professionals in the area, through better education and training. They might also want access to information on drugs given in everyday language. The carers plan could help to indicate where such information would be available. Carers might also want to know how to get access to information about new therapy changes and new support for carers at crucial times. Again, a carers plan could help to identify where such support was available locally.

The Parkinson's Disease Society is campaigning hard to achieve the target of having some 240 Parkinson's disease nurse specialists. At present, there are 75 in post, and they provide particular support to patients and carers across the United Kingdom. A carers plan could help to identify which local authorities have access to such nurse specialists, and could help to encourage other local authorities to put pressure on the health authorities with which they are in partnership to make funding available for more Parkinson's disease nurse specialists.

The Parkinson's Disease Society has made it clear that respite care is extremely important, and that it wants an increase in the provision of high-quality respite care services. A carers plan could help to show which local authorities were expanding their respite care services for those with Parkinson's. The society has said that the provision of emergency respite care is also crucial, so that a crisis affecting the carer does not result in the patient being placed in a residential setting. In an emergency, carers want immediate access to information on getting respite care as soon as possible. A carers plan might help to ensure that local authorities provide such information.

I flag up again the important issues of helping carers stay in touch with, or return to, the world of work. Thanks to Ministers in other Departments, carers now benefit from ONE, the single gateway, which brings together the Employment Service, the Benefits Agency and other welfare providers at a single point of contact. A carers plan would help to identify that single point of contact. The ONE service is a significant change in the service that clients currently get from the benefits system. The Government have said that they want carers and people with disabilities to hear about the help on offer, to allow them to make informed choices about whether to utilise the ONE service to enhance their employability in the short or longer term. Clearly, no client would be forced to look for work or to take any step following a persona] advice meeting, but carers need to know where they can get access to such a service if they want to, and a carers plan would help in that respect.

My hon. Friend the Minister said in Committee that the Government would publish

a new quality Green Paper on social services later in the year which will outline ways of providing better guidance to local authorities…

that is the point that my hon. Friend the Member for Rother Valley (Mr. Barron) made in an earlier intervention—

in relation to cost-effective quality social care interventions.

He also said that the Secretary of State for Health had

floated the possibility of a new social care institute of excellence…—[Official Report, Standing Committee C, 8 March 2000; c. 9.]

What better task for a new social care institute of excellence to begin with than looking at the carers plans produced by local authorities. What better way of showing carers the new guidance, through local authorities, than the publication of a carers plan.

My hon. Friend the Member for Halesowen and Rowley Regis (Mrs. Heal) spoke in the same debate about carers of people who are mentally ill. A carers plan could make a powerful contribution to identifying the support available to carers.

I am reluctant to intervene on my hon. Friend while he is making his speech. However, the national health service framework for mental health, which was published in September last year, makes it clear that it is the responsibility of local authorities to provide a written care plan for those looking after people with mental health problems. That is also a sign that the Government are trying to ensure that carers feature prominently in service improvement right across the range.

I am grateful to my hon. Friend for that intervention. I think that a carers plan can only help to make it clear where people can go to get access to information about assessments.

Amendment No. 10, in my name, suggests inserting the words

in consultation with the carer

after "decide". This a probing amendment, which simply reinforces the obvious point that services for carers should be provided in consultation with them. We are not interested in recreating big brother; we are not saying that the local authority always knows best. The amendment would reinforce the point that services should not be provided on the basis of somebody remote from the carer deciding what is best, but in consultation with the carer.

I hope that in my few words I have explained properly to the House how a carers plan provision could benefit the Bill.

In spite of the eloquence of the hon. Member for Harrow, West (Mr. Thomas), to which I pay willing tribute, I confess that he has not carried me very far with him. I am worried about the extent to which the hon. Gentleman believes that the act or preparation of planning would resolve so many questions.

I confess at the outset that I have an instinctive unease about planning per se. I am now old enough to remember the national plan back in 1964, when George Brown told us that it would be the salvation of the nation. That did not last long, and I am surprised to hear that new Labour—to which, no doubt, the hon. Gentleman would want to attach himself—still holds that rather naive belief in the benefits of planning.

11 am

Setting that general objection to one side, I remain unclear, despite the pains that the hon. Gentleman took to explain his objectives following the intervention by the hon. Member for Sutton and Cheam (Mr. Burstow), about quite what he thinks the planning process would do. His ideas seemed to encompass the provision of information, which is not what I would regard as the normal objective of planning. On the other hand, they seemed to be about reassuring carers, which plans might or might not do. Thirdly, they seemed to be about setting out transparently the objectives of authorities and the way in which they proposed to meet the Bill's requirements.

The third of those objectives is the most legitimate and useful, but the hon. Gentleman's new clause does not make it explicit. In fact, it says very little, and it does not properly elucidate or pin down the many objectives that he set out. If we were to support the new clause—I would find great difficulty in doing so—I cannot see that it would add anything to the Bill's objectives or the proper provision of services to carers. It is too general, and would have to have been much more specific to be of any use.

Is the hon. Gentleman trying to reassure carers? Is he trying to reassure the Government by meeting the objectives either of their guidelines or regulations? I could see some point in that, but I am not sure that that was his objective. He hinted that the new clause would facilitate effective co-operation between the authority and, say, local health service bodies. There might be some point to that, but there was a lack of focus in what the hon. Gentleman said and in the simple wording of his new clause.

Responsibility for preparing the plan would clearly lie with the authority—at least, I think that that is clear. We need not question who in the authority would have to do that, but there is the time-honoured question of cost. The hon. Gentleman, understandably, did not deal with that, but we all know that planning carries costs. We must ask whether we believe that sufficient additional benefit—added value, in the ghastly modern jargon—would arise to justify the cost. Would not the money be better spent more directly on providing the services that are the Bill's objective? Unless we have a more accurate idea of the cost of the process suggested in the new clause, it is difficult to judge those points. Unless I were to be much more persuaded of the benefits, my feeling would be that the cost would be an unacceptable additional administrative burden on the local authority.

I have listened carefully to the right hon. Gentleman and I sense a certain inconsistency in his argument. On the one hand, he says that the costs of preparing the plan are too great; that we must know what we are doing; and that it might be better to spend the money directly. On the other, he has suggested that we must know what we would be spending the money on but, in order to know that, the plan would have to have been prepared. There is a certain circularity in the right hon. Gentleman's arguments.

I see what the hon. Gentleman is driving at, but spending the money and preparing the plan would occur anyway. That would not be additional, as that process already happens. The new clause suggests a burdensome additional administrative and bureaucratic process, which would cost even more. Plans do not come free, as anyone with even limited local authority experience will know. Whatever additional benefits may accrue from the process suggested by the hon. Member for Harrow, West—I have my doubts about them—I suspect that the costs will not be justified. The risk is that that additional cost would come from moneys that could be more directly used to fulfil the purposes of the Bill.

May I take the right hon. Gentleman back a year? The requirement that went with additional money provided through the carers special grant was that each English local authority had to produce a carers plan. The vast majority did so, increasing the partnership with health authorities and increasing services. If they could do that last year, surely they could do it in future.

That puzzles me even more. Back when the hon. Gentleman opened his remarks on the new clause, he set out in detail what already happened, and then seemed to want more, or the same again, or a reiteration of what we do, or some such thing. For that reason, the entire new clause seems otiose. He has just reinforced my doubts by telling us that all this is more or less done already.

The carers plan was produced because a specific requirement for it was linked to the money from the Government for the carers special grant. That was a one-off requirement. Unless my new clause is successful. there will be no reason why local authorities will have to produce a carers plan in future. I contend simply that if it was successful last year, we should roll on that success to future years.

That intervention raises several further questions. First, if the process was successful, authorities would presumably—at least, possibly—want to follow it again. Secondly, the extent to which the process was deemed to be a success would in itself affect whether it should be repeated. It is implicit in the way in which the Bill's ethos has been debated at every stage that we all assume a large amount of good will on the part of the Government and the local authorities.

As a condition of this year's use of the carers grant, local authorities will be required to provide an updated version of their original plans. The planning obligation still features as part of the special grant regime.

That enables me to curtail my remarks, the House will he happy to hear. That seems to lay the whole matter to rest. I shall move quickly on to my concluding remarks, which relate to what the Minister has said.

I assume that, as there is a requirement for a plan, there is also a requirement to ensure the plans are satisfactorily and usefully drawn up. While the hon. Member for Harrow, West was speaking, it occurred to me that there was no provision in his remarks for any quality assurance. The process seemed unsatisfactorily loose, and I should like to hear from the Minister—following his extremely helpful intervention—an assurance that the process was satisfactorily carried out last year, and that mechanisms are in place, involving his officials or guidelines and the authorities who draw up the plans, to establish that the plans have a proper use and do much, if not all, of what the hon. Member for Harrow, West wanted. Can the Minister assure us that they would provide added value to the support and assistance that would be given to carers by the Bill? That is the main outstanding question.

I do not wish to speak for long. The Minister's recent intervention on the right hon. Member for Bromley and Chislehurst (Mr. Forth) goes some way to meeting my concerns. I am grateful to my hon. Friend the Member for Harrow, West (Mr. Thomas) for raising the matter, but I would find it difficult to support him. His speech was extremely well researched, and he made good points on several issues, particularly on hospital discharge and how carers, or people in the primary health care sector, gain information on the issues. Occasionally, they do not receive a service that is as good as today's information technology could provide. We should consider that issue.

Although I agree with many of the arguments made by my hon. Friend the Member for Harrow, West, I point out that, in the 1980s, my family had to deal with someone who had Alzheimer's disease, when there was little medical analysis of her condition. We cared for her within the family for many years; it was only at her death that she was found to have the disease. I do not criticise anyone involved, but the support services from the local authority and the health authority were pretty poor. Needs were not well met. That has changed, even though it is not enough to satisfy all individuals and organisations—I accept that entirely. However, matters have improved. During the past two decades, care for such people has become much better.

One of the points on which I disagree with my hon. Friend is that new clause 2 would give responsibility for drawing up the carers plan to the local authority. I am not attacking local authorities. I am a great believer in local democracy and in decisions on people's lives being taken as locally as possible. When we draw up legislation in this place, we do not know all the answers to people's needs. We may think that we do, but often we do not—as we find out later.

The important point is that the matter goes much wider than local authorities. The health authority has a large role in helping carers and people with disabilities to manage their lives in general. To suggest—as the new clause does—that local authorities should carry out that task on their own is not a good way forward.

I am sure that my hon. Friend the Minister will tell us—as he observed in his intervention—that there are other ways to handle the matter. Although I am sympathetic to care plans—as we all should be—because they give people rights, they also raise expectations. At present, there are different levels of care in local authorities and in health authorities. My fear is that, if we ask authorities to produce local care plans, those differences could be compounded and justified. In order to assist carers, what we should be doing is ensuring that best practice is observed throughout the system; we should improve matters for people and those being cared for as much as we can. To ask local authorities to draw up and justify care plans under the current system is probably not the best way to do that. We need improvements throughout the country rather than merely justifying the current system—as I suspect would be the effect of new clause 2.

There seem to be two contrasting aims in new clause 2, as it was elaborated on by the hon. Member for Harrow, West (Mr. Thomas). If there is a disparity between the services provided by local authorities, there may well be justification for a document that analyses that disparity, so that those offering a service that is less good can improve it. However, it is easy to list a load of problems, establish an institutional reform and sweep everything into that dustbin. The hon. Gentleman outlined many problems in some detail and stated that the carers plan would resolve them. That would be our Aladdin's cave.

The problem is that a document that describes the differences between local authorities will be an extremely broad one and thus it will inevitably be bland. That will not help the people who need it. We all hear of traumatic cases—those are the people we should be thinking about. If the carers plan is to be really effective, it will have to consider almost every individual case.

Carers are being treated as a homogenous lump, but every carer is dealing with an individual problem. Many are in families, where, for example, an isolated elderly person has Alzheimer's. They have to cope with the whole range of disabilities—physical and mental—or with different physical surroundings. Some people may be in blocks of flats with wardens; others—as in my constituency—may be in isolated cottages in the countryside. Some people are caring for children. I know of one especially traumatic case involving a quadriplegic child who is completely mentally and physically disabled and will need care for her whole life.

As the hon. Member for Rother Valley (Mr. Barron) pointed out, to help such people effectively, we need an individual plan for every case. That is an ambitious project. It would obviously need a large number of staff and skilled people and large resources. It might be prohibitively expensive.

There might be merit in drawing up carers plans for individual cases, but I am not sure that the hon. Member for Harrow, West has really thought the matter through. There is a contrast between an effective plan that would help those individuals and a broad, bland document that compared disparities between the services delivered by local authorities.

I shall be interested to hear how the Minister intends to resolve the matter. It would be easy to establish a carers plan and say that all the problems outlined by the hon. Member for Harrow, West will go away—but they will not. To be effective, we need to focus much more on the detail, but to do that will be extremely expensive and time-consuming.

11.15 am

Before I respond to the debate, I thank all those who spoke of my incapacity to undertake my proper role of speaking longer than my hon. Friend the Minister, who spoke earlier on my behalf. When he pointed out that I had left my sick bed to be in the Chamber, Members sitting close to me scattered. Only my hon. Friend the Member for Denton and Reddish (Mr. Bennett) was either brave or foolhardy enough to remain within reach.

Any of my hon. Friends who believe that the right hon. Member for Bromley and Chislehurst (Mr. Forth) does not have a big heart and that he does not care about people should read Hansard on Monday. I am grateful for what he said.

My hon. Friend the Member for Harrow, West (Mr. Thomas) introduced the new clause thoughtfully and well. I greatly appreciate the efforts that he put into the new clause and the amendments. I shall deal with the amendments as a group, because they cover the responsibilities of local councils to decide which services they provide to carers and how. It is right to put carers in that position. I understand why hon. Members have tabled amendments. Like all of us, they want carers to receive the services they need—we are all agreed on that. However, as has been pointed out, all the new provisions are either unnecessary or would reduce a local council's ability to make effective decisions based on its own eligibility criteria and on the professional judgment of its assessing staff.

In relation to community care, we must also be very careful not to put carers in a position that is preferable to that of the people for whom they care. We do not want to give the impression of discriminating against service users in favour of carers. We do not want to impose a duty on local councils to provide services to carers—we simply want to empower them to do so. Amendment No. 10 would reinforce what is already clearly understood to be a fundamental principle of good practice in both service users and carers assessments. In the latter case, practitioners are left in no doubt about their responsibilities to hold consultations with carers. Under the Carers (Recognition and Services) Act 1995, the policy and practice guide on the content of a carer's assessment includes such matters as the carer's perception of the situation, the nature of their relationship with the user, the tasks undertaken and the consequent impact on the carer and the tasks with which they would like help.

My hon. Friend the Minister has already made a helpful intervention on that point. I am sure that he will want to say more. However, I know that he is adamant that similar unequivocal guidance will be issued if the Bill receives Royal Assent. I therefore ask my hon. Friend the Member for Harrow, West to be reassured and to withdraw the amendment.

Amendment No. 13 similarly seeks to remove the local authority's ability to judge whether particular services will help a carer. As I have said, good practice dictates that such a decision will follow discussions with carers, very much taking their views into account. It must also be made within the parameters of the council's eligibility criteria, which will prioritise within the council's resources the support of those with the greatest needs. If the final arbiter of the appropriateness of a service were not the local authority, whose view would matter? If the decision fell to carers, they would once again be in a better position than the service user, and that can be seen only as discriminatory. I therefore ask my hon. Friend the Member for Hendon (Mr. Dismore) not to press his amendment.

Amendment No. 11 would impose a statutory duty on local authorities, rather than create a power to provide services to a carer following an assessment of need. I would not want—I am sure that no hon. Member would—carers to be put in the position where the people for whom they care have no such right. I therefore urge my hon. Friend the Member for Halesowen and Rowley Regis (Mrs. Heal) not to press her amendment.

On amendment No. 14, the Bill enables local councils to offer carers support in order to meet their assessed needs as carers or to maintain their health and well-being. That support or assistance is expressed as

the delivery of a service.

The term is generic and includes assistance in the form of, say, a direct payment, which would enable a carer to purchase the services to meet the assessed need. On the basis of that explanation, I urge my hon. Friend the Member for Erith and Thamesmead (Mr. Austin) not to press his amendment.

I understand that the purpose of new clause 2 is to ensure that the legislation is properly considered and that councils give thought to the provision of services and also support carers as they carry out their caring role. I understand from my hon. Friend the Minister that the Department of Health would expect such an exercise to be conducted as part of the on-going planning and priority-setting work of social services departments. I am sure that my hon. Friend will wish to say more about that, but for those reasons I ask my hon. Friend the Member for Harrow, West to withdraw the new clause.

I shall try to be brief. I certainly lend my support to my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) in his unwillingness to accept the group of amendments and the new clause, and I endorse all the arguments and his reasons for doing so.

Like my hon. Friend, the Government are committed to striking the right balance. We want to empower carers—of course we do. That is precisely the thrust behind the national carers strategy and, in fact, the main thrust of my hon. Friend's Bill. Several references have been made, including by my hon. Friend the Member for Harrow, West (Mr. Thomas), to the practical ways in which the Government are expressing their support for that commitment. They include the special carers grants that total £140 million, which will be made available over the next three years to provide carers with additional-break services. Several hon. Members have referred to the conditions that relate to the use of that grant, about which I shall say one or two words in a second.

It is important that we strike the right balance, as my hon. Friends have said. While empowering carers, we must be careful to ensure that there is no diminution of the rights of those who receive support from carers. We cannot allow the needs of those who are cared for to be recognised any less or their statutory rights to appear in any way less favourable than those of carers. We must have consistency and fair treatment between carers and those being cared for. For the reasons that my hon. Friend the Member for Stalybridge and Hyde has expressed, amendment No. 11 would make it harder for us to maintain such a level playing field.

The Government are committed to promoting the independence of disabled people. We have set up the Disability Rights Commission, for example, and are hoping under the Bill to extend the direct payments scheme. The best way of supporting carers is often to support the service user as flexibly as possible. I know that my hon. Friend the Member for Stalybridge and Hyde has been only too mindful of the need to strike a balance between the interests of service users and of carers.

The Government want councils to have the flexibility to support carers in ways that best meet their needs without compromising the rights of service users. We therefore welcome the approach of my hon. Friend in giving local authorities a duty to assess on request, but a power to provide services that they deem appropriate under their eligibility criteria. Such important eligibility criteria for carer services do not exist at the moment, but we will ensure—I am sure that the House will want us to do so—that policy and practice guidance on the Bill, when it is enacted, will support councils in developing them.

Other work to support that important process is in fact already under way. An equitable approach to meeting the needs of service users and carers is a key plank of the Government's policy. Over the coming months, as my hon. Friend the Member for Harrow, West said, policy and practice guidance on a new initiative to ensure consistency in social services eligibility criteria will go out for consultation among local authorities and others. When the comments received have been duly considered, guidance will go to councils on how best to ensure greater consistency and transparency in implementing future eligibility criteria. I say to my hon. Friends the Members for Harrow, West and for Rother Valley (Mr. Barron), who has an interest in the matter, that such guidance will have statutory effect under the Local Authority Social Services Act 1970.

If the Bill receives Royal Assent, the Department of Health, as my hon. Friend the Member for Stalybridge and Hyde has pointed out, will make good use of the opportunity to revise and strengthen the guidance for practitioners who conduct carer assessments. As my hon. Friend rightly said, the full participation of carers will form a crucial part of that guidance. So, for the reasons that he has made clear, amendment No. 10 is not necessary. We shall also seek to address the fact that there has never been a simple, carer-friendly guide on carers rights, which we shall put right, too.

On new clause 2, I find myself in the rather odd position of agreeing with the right hon. Member for Bromley and Chislehurst (Mr. Forth). We shall have to keep that between the two of us. We need to be careful not to add unnecessarily to local authority planning obligations. In fact, I think the opposite; we should be looking to simplify the planning requirements that we place on local authorities.

As my hon. Friend the Member for Rother Valley rightly pointed out, we should be encouraging greater co-operation between health authorities and local authorities. If we approach the issue of carer services from the perspective that I am afraid underlines the new clause, responsibility will fall entirely on local authorities. I understand why my hon. Friend the Member for Harrow, West has phrased the new clause in such a way, because the Bill is about local authorities, but to place the planning responsibility for improving carer services solely on councils would be to misunderstand the nature and purpose of this entire area of social policy. We must ensure that we encourage greater partnership between health and local authorities in improving the way in which all local authority services for carers are delivered.

My hon. Friend, who obviously takes a very close interest in such issues, will want to know that there is much work under way to improve the planning process in the area. He will be aware, although he did not refer to it in his speech, that we are trying to encourage health and local authorities to develop new joint implementation plans locally in a number of key areas which will benefit and interest carers, including learning disability, mental health and services for older people. In all such areas, a significant amount of work is under way. My hon. Friend also rightly referred to the way in which we are intending to ensure that we raise the quality and level of social services performance through, for example, the development of our new performance assessment framework, which will be of particular benefit to carers.

My hon. Friend the Member for Stalybridge and Hyde was right to say that, if the Bill receives Royal Assent, the Government intend that planning for carer services should become part of the mainstream of planning and priority setting in social services. Local authorities are, of course, already preparing plans under section 46 of the National Health Service and Community Care Act 1990. Those plans are an important source of information for non-statutory bodies and, of course, the public—I know that my hon. Friend the Member for Harrow, West is interested in empowering members of the public—on how an authority intends to implement its community care responsibilities. Local authorities are required by the 1990 Act to consult widely on those plans. Statutory directions that emphasise the need for authorities to consult all those involved in community care, including representatives of independent-sector providers, other agencies, such as health and housing authorities, and representatives of both user and carer groups, have been issued.

11.30 am

The guidance on preparing plans helps to ensure that local councils adopt a long-term strategic outlook to community care planning. It encourages better joint planning between local health and housing authorities and full involvement of relevant local agencies in the successful delivery of high-quality care. The guidance is also designed to provide stronger partnerships between all agencies involved in the delivery of community care and with users and carers themselves. It is consciously generic so as to provide a firm foundation to underpin the many other programmes and plans that local authorities prepare. In addition, there are the plans that local councils are revising and reviewing as a condition of receiving the three special grants to promote independence. They do that through breaking down barriers between health and social services, encouraging early intervention to prevent crises, and supporting carers who wish to continue to care.

As I said in an intervention on the right hon. Member for Bromley and Chislehurst, the revised plans for the spending of the carers special grant for this financial year must be sent to the Department of Health by the end of May. The right hon. Gentleman was concerned whether we were satisfied about the adequacy of those plans and the arrangements for making sure that the money is spent in the way that we intend. I assure him that we are satisfied in all those respects. We take a very close interest in ensuring that the money that Parliament provides to support carers services is spent on carers services, and not anywhere else.

This has been a helpful debate in that a number of centrally important issues on the development of carer services have been aired. For all of the reasons that my hon. Friend the Member for Stalybridge and Hyde spelled out, and given the extra assurance that I have been able to give about aspects of how the Government intend to implement the Bill and to develop services in the future, I hope that my hon. Friend the Member for Harrow, West will not press the new clause to a vote.

rose—

Order. May I say to the hon. Lady that it makes for orderly debate if Members seeking to speak to an amendment that they have tabled or to make a contribution to a group of amendments speak when they are given the opportunity to do so earlier in the debate? We have now had a reply from the promoter of the Bill and the Minister. There is no automatic right to speak a second time, so any remarks made now might not be answered.

Thank you, Mr. Deputy Speaker. I certainly thank you for your indulgence and I apologise for being remiss in not catching your eye earlier.

Order. I should perhaps also say that I had received an—indirect it is true—message from the hon. Lady that she did not intend to speak. That is why we find ourselves in this situation.

Thank you very much, Mr. Deputy Speaker, for giving me this opportunity to speak. I will restrict my remarks, having heard the comments already made.

I tabled amendment No. 11, which would leave out "whether or not" and insert "how" on page 2, line 8. It relates to local authorities and assessments. It is important for us to stop and consider the position in which many carers finds themselves. The amendment is about implementation of the clause. It would ensure that uncertainty for carers is removed. Clause 2(b) already refers to whether a local authority

could be satisfied (wholly or partly) by services which the local authority may provide.

My amendment would make the local authority address the question of how those services will be provided. The Bill already makes sufficient reference to give the authority discretion if that is so required when the assessment has been completed.

Uncertainly and lack of information have existed for far too long for carers. They are unsure whether they are entitled to services and, if so, what those services will be and, more important, how and when they will be delivered. The "how" is important, because how the services are delivered may enable many carers to live some of their lives and may provide them with some quality of life in addition to the care that they offer to a disabled person. They may have the opportunity to take a break themselves or to continue working. Therefore, how and when services are provided is a crucial issue.

I craved your indulgence, Mr. Deputy Speaker, in allowing me to speak to the amendment. I hope that it still may be considered or that, at least, my remarks on it will be considered by the Minister.

I apologise to you, Mr. Deputy Speaker, for not rising earlier. I had expected to follow my hon. Friend the Member for Halesowen and Rowley Regis (Mrs. Heal).

I shall make a couple of brief points about the amendments and in particular amendment No. 14. I want to follow up a point made by the Carers National Association about the definition of services for carers. It is concerned particularly about transport for disabled people to and from day centres and it fears that the way that the Bill is currently drawn could mean that that becomes defined as a carer service, because it would help a carer to care and would provide respite time while the person being cared for is at the day centre.

The association says that the clause's wording is problematic because it introduces the possibility that carers could be charged for services that were previously considered to belong to the user. I shall amplify that point when we come to my amendment to clause 7.

On Second Reading, an indication was given that the issue would be considered at a later stage, perhaps on Report. As far as I can tell, it has not been addressed, so I hope that my hon. Friends the Member for Stalybridge and Hyde (Mr. Pendry) and the Minister, who unfortunately have already replied to the debate, will bear my points in mind as the Bill progresses, I hope, to its later stages.

I want to respond briefly to what has been a useful debate. I fear that I have perhaps not carried the House with me on the new clause. I have ranged against me my hon. Friend the Members for Rother Valley (Mr. Barron) and for Stalybridge and Hyde (Mr. Pendry) as well as my hon. Friend the Minister, not to mention the perceived alliance with the right hon. Member for Bromley and Chislehurst (Mr. Forth).

I am grateful to my hon. Friend the Minister for his assurances and very much welcome the fact that a carers plan will be required because of the special grant moneys that will be available next year. Therefore, I beg to ask leave to withdraw the motion.

Motion and clause, by leave, withdrawn.

Clause 1

Right Of Carers To Assessment

I beg to move amendment No. 1, in page 1, line 5, leave out "16" and insert "14".

I have a sense of déjà vu in raising this issue. On Second Reading, it was one of the concerns that I flagged up when I said:

The Bill provides additional facilities for carers aged 16 and over.—[Official Report, 4 February 2000; Vol. 343, c. 1377.]

I wondered then whether we should not consider in Committee—I do not think that it was considered there—whether 16 was the right cut-off point. I thought that there was a case for including even younger carers.

When I researched my Second Reading speech, I was staggered to learn from the national carers strategy, which I shall refer to shortly, that between 20,000 and 50,000 young carers look after parents or elderly relatives and that many of them receive no support from statutory or voluntary services. It was in that context that, after Second Reading, I started to do a bit more digging on the issue, and that led me to table the amendment that would reduce the age to 14.

To get more local background information, I spoke to the young carers project which operates in Barnet and Hendon. It is an interesting project which is jointly financed by the London borough of Barnet, Children in Need and the Millie Apthorp trust. It is based at the friends in need joint project in Barnet. The project told me that, in its view, young carers include anyone from the age of six to the age of 18. Indeed, it has on its books several carers who are aged six and who have to make a contribution at home. It is staggering that children as young as six are getting involved.

The amendment does not suggest that children of six should be able to request the facilities to be provided by the assessments in the Bill, but there is a case for considering an age younger than 16, which is the school-leaving age. I suspect that many of the carers who would be caught by the Bill as it is at present phrased would be over the age of 16. We know, however, from research to which I shall shortly refer, that children sometimes find that their school work is affected. The age of 14, when children start doing GCSE courses, would be an ideal point at which they could become eligible to request additional assistance from the local authority.

Some local authorities are starting to address those needs. I mentioned the young carers project in my borough which is trying to work with the local authority and to build links with GPs and schools to help to identify and support young carers. The biggest problem is identifying carers and getting them to come forward. Nobody really knows how many young carers there are in my area, but the best, conservative estimate that I have been given is that there are 200 or more. They desperately need help, but that help must be specifically targeted at younger carers' needs. By reducing the age in the Bill, and thereby including a younger age group in its provisions, we may be able to address young carers' concerns.

Examples of what the project in my constituency does will inform the argument. It organises time-out meetings at which young carers can meet other children in the same position and age group. The idea is for them to meet and socialise, and not necessarily to discuss their caring responsibilities, although I suspect that they do. The project provides an after-school drop-in service with support, information and advice, which is specifically geared to the needs of young carers. Those services are targeted at that particular age group, which my amendment seeks to address.

The project organises monthly outings, and next Saturday it will take young carers to TGI Friday, the hamburger restaurant. That may not seem a big deal to many people, but it is a big deal for those young carers. If they have a disabled sibling, it can be problematic for the family to go to a restaurant together, and enabling young carers, as a group, to take advantage of that facility is a brilliant idea. Such ideas could well be overlooked if we do not consider the amendment, which would help to identify the particular needs of young carers. The project also runs workshops in schools to try to raise the awareness of children who may not realise that they are carers—they may have drifted into caring. There are also drop-in sessions in schools.

"Caring about Carers", the national strategy document, devotes a chapter to young carers, and I want to highlight one or two of the problems that particularly affect those in the age group that we are discussing. The document says that they may have to care for

a parent with a physical illness, disability…or dependency on alcohol or drugs.

They may have to look after

an elderly grandparent who is frail, or who has a health problem or disability

or, as I have just said, a sibling with a health problem or disability.

The strategy particularly highlights the problems facing children in single-parent families in which the parent is in need of support. Those children are particularly likely to spend a large part of their time providing care. Amending the age specified in the Bill to 14 would help those children. Fourteen-year-olds are starting to want to be independent and to develop their own life, but carers, particularly those in single-parent households, find it difficult to do so, not least because of financial constraints on the family. We must enable local authorities to meet the needs of carers aged 14 and over by allowing the carers themselves to ask for assistance. That is what my amendment seeks to achieve, and it would start to address their needs.

We know from the strategy of the problems that carers experience at school, particularly with homework and qualifications. If they can receive assistance outside school, through respite care or a drop-in centre, they may be able to prepare for their GCSEs, free from their caring responsibilities, for two or three hours in the evening. We know also of the problems of isolation from other members of the family.

The strategy identifies the lack of time that young carers have for play, sport or leisure activities. That is exactly the sort of problem that the young carers project in Barnet is trying to address. My amendment would provide great support to those children by enabling them to make their position known to the local authority and have their needs recognised.

11.45 am

Under section 17 of the Children Act 1989, social services departments can help young carers by considering whether their welfare or development might suffer if support is not provided. The Bill tries to go beyond the existing narrow definition used in providing assistance to carers, and my amendment would strengthen the position of that age group and go beyond the provisions of the Children Act by giving them more rights.

Under the Carers (Recognition and Services) Act 1995, young carers can ask for an assessment of their needs, but many are not aware of that. Some local authorities are reluctant to advertise the fact because they are concerned about raising expectations. The Bill is trying to raise expectations and to fulfil them. If we do not recognise that younger carers are reluctant to come forward and ask for their needs to be recognised, we run the risk of creating a loophole in the Bill. Fourteen-year-olds are of an age when they begin to make their views known, and by reducing the age in the Bill to 14 we can empower them to do so.

The amendment will also strengthen the hand of projects such as the one in my constituency when they visit schools to raise young people's awareness. They will be able to tell 14-year-old carers that they have rights and should ask the local authority to assess them and meet their needs, and that the project will assist them in doing so.

There is a strong argument for the amendment, and it applies not only to 14 to 16-year-olds, but to carers in single-parent families, whom I have mentioned, and carers from minority groups. We know of their problems from the national carers strategy. I dealt with that issue on Second Reading so I shall not do so again, but those carers have special needs that need to be identified.

We can use the Bill to help carers aged 14 to 16 by working with local authorities, schools, projects and GPs to try to identify young carers and to provide them with support. With those brief remarks, I hope that I have made a case for reducing the age limit to 14 which will at least be answered by the Bill's promoter. Let us try to empower young people, who are getting older at a younger age, if hon. Members see what I mean. We need to take a little more responsibility for them, particularly at the time in their life when they need additional help with their schooling.

I am rather unhappy with the argument for a number of reasons. The hon. Member for Hendon (Mr. Dismore) referred in passing to the Carers (Recognition and Services) Act 1995, which interestingly says in its definitions that

"child" means a person under the age of eighteen.

I set aside that fact, as well as recent debates in the House and in another place, about ages of consent.

What really bothers me is that the hon. Gentleman apparently not only sanctions but encourages the concept that someone as young as 14 should be given the enormous responsibilities of being a carer in the full sense of the word. That may well happen, and in some circumstances it may well even be unavoidable, but do we want to go so far as sanctioning it by including it in an Act of Parliament?

I understand the hon. Gentleman's argument that we should give statutory recognition to what is already happening, but I would rather go in the other direction and have a community and governmental responsibility for trying to ensure, as far as possible, that no 14-year-old has the full responsibility of being a carer. Certainly, that should not be sanctioned by law, which would be the effect of the amendment.

I go further: where there are financial implications, as there are in the Bill and in other statute, should we be entrusting taxpayers' money to someone who is 14 years of age? I take a different view of youth from the hon. Gentleman. I believe that one of the big mistakes that we are making is to try to hustle young people into adulthood and responsibility too early. I regret that young people these days seem to have shorter and shorter childhoods and seem to be hustled in every conceivable way into what I would style premature adulthood. The amendment strikes me as yet another step in that direction. That is why I have severe reservations about it.

I am just about content with the fact that the Bill defines the age as 16. It does not make me particularly happy that someone of that tender age should have such responsibilities, but I suppose that, in practice, one has to go along with that as a reality of modern life. However, I would certainly want to resist any effort to reduce the age further. I hope that either the promoter of the Bill or the Minister will be able to reassure me that what they have in mind is that we should try to alleviate any responsibility that may rest with 14-year-olds as much as we possibly can. I grant that, in some circumstances, such responsibility may be unavoidable, but our objective should be to use the panoply of existing legislation and to use the Bill, which I hope will become an Act, to that end.

I hear what the right hon. Gentleman is saying. There are occasions when circumstances arise that are unavoidable. Should we not offer young people the protection and support that they need when those circumstances do arise?

I hope that that would take place in any case. I hope that the existing mechanisms and those that the Bill seeks to add would do that. What I am resisting is that we sanction and write into legislation the fact that we almost expect people as young as 14 to fulfil those responsibilities—we risk formalising that.

I accept what the hon. Gentleman is saying—we must try to ensure that wherever that terrible responsibility is placed on someone of those tender years, they get the fullest possible support and the requirement is placed on them for as short a time as possible. That is a world away from building the matter into legislation and saying, "Well, because we are making the provision, we assume that it will happen." It would not take a lot to persuade me that we should make the relevant age higher than 16, but that is not a debate for today. I am content to stick with the Bill as it stands. For that reason, I oppose the amendment.

May I first say that I am grateful for the way in which my hon. Friend the Member for Hendon (Mr. Dismore) proposed his amendment, but I have more in common with the right hon. Member for Bromley and Chislehurst (Mr. Forth). That alliance seems to be continuing—long may it continue during this day. The amendment would give young carers aged 14 and 15 the right to an assessment under the Bill of their ability to provide and to continue to provide care and the right to receive services either directly or via direct payments on that basis.

We have to consider carefully the position of young carers. Some of them are old enough—it is true—to be able to undertake a reasonable level of caring responsibility and they will do so willingly out of love for their parents. It is entirely proper that that goes on in families in the ways that families think best.

Other young carers are obliged to undertake levels of caring responsibility that actually harm their future prospects as they miss out on opportunities of education, leisure pursuits, time with friends, part-time work and so on. The Bill must send the right message about young carers—they should not undertake levels of caring that are damaging and they should receive the most appropriate levels of support.

My hon. Friend the Member for Dumfries (Mr. Brown) intervened, rightly, to ask a particular question. At the moment, young carers receive valuable support from local authorities. They are seen as children in need under the Children Act and services are provided that safeguard and promote their welfare. The amendment would enable 14 and 15-year-olds to opt to be treated in the same way as adults who choose to care and are caring on a regular and substantial basis. They could, for example, if given a right to request an assessment under the Bill, request direct payments instead of receiving services directly from their local council.

In my view, when young people of that age are also carers they already have too many responsibilities. We want to relieve those burdens, not run the risk of adding to them, so I would wish to be assured that councils were delivering adequate support to the service user, so that young persons were not undertaking a substantial and regular load of caring responsibilities. I am sure that the House would agree that we do not want young carers' futures blighted by their caring responsibilities, thus undermining their need to participate fully in education and leisure activities.

I have, as the House will have noted, included young carers aged 16 in the Bill—some people are quite unhappy but are prepared to live with it, as the right hon. Member for Bromley and Chislehurst has said—because there are a small number of situations in which a 16 or 17-year-old is choosing to undertake a substantial and regular caring role for a period: for example, if a parent is terminally ill. In those circumstances, it could be more helpful in terms of the young person's personal development for their local council to support them actively if they positively choose to adopt a role that one would otherwise wish to ensure they were not burdened with.

I hope that my hon. Friend, having listened to those arguments, will not press his amendment, because I do not believe that it helps 14 and 15-year-old carers. I hope that, on that basis, he will agree to withdraw his amendment.

I support the comments of my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) and those of the right hon. Member for Bromley and Chislehurst (Mr. Forth). My hon. Friend the Member for Hendon (Mr. Dismore) is a lawyer; I am a lawyer; there are lots of lawyers in this place, and we all know that when we make legislation, it is, by definition, about where we draw lines. Under the Bill, we are extending choice and flexibility to young carers—for example, through the extension of the direct payment scheme. My hon. Friend the Member for Stalybridge and Hyde has made a judgment about where that line needs to be drawn. We fix it in the Bill at 16 because we feel that it is the appropriate place to establish that line.

The amendment would raise exactly the sort of scenarios to which both my hon. Friend the Member for Stalybridge and Hyde and the right hon. Member for Bromley and Chislehurst have referred—14-year-olds would receive direct payments. On that ground alone, we need to consider some serious issues of public policy, quite apart from the separate issues that they have referred to in relation to the wider responsibilities of young people and young carers in our society.

By way of information, I should say to my hon. Friend the Member for Hendon, in case he is concerned about his amendment and its relationship to the Bill, that my hon. Friend the Member for Stalybridge and Hyde was right to point out the existing protection and support that the Children Act provides to young carers, as they can be considered as children in need. He will be aware, too, that this year, as part of the conditions relating to the use of the carers grant, it will be possible for local councils to support, for example, young carers projects. I am hopeful that local authorities will use their freedom and discretion to do that.

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Additionally, my hon. Friend the Member for Hendon will be aware that the Government are supporting a range of other programmes to provide better support in meeting the needs of younger people. I draw his attention to the additional resources going to support child and adolescent mental health services. Although some hon. Members may question the relevance of such services to this debate, they are relevant to it, as one aspect of such services may well be to provide the counselling and support that is crucial in enabling young people to continue their caring responsibilities, perhaps to members of their own families.

All hon. Members will be aware from constituency case work and from knowledge of our own families of the stresses and strains that caring responsibilities can create for young people. The right thing to do if we are to ensure that services are available to meet the needs of young people is to ensure that appropriate services are available locally, supported by national health service trusts and local authorities, to provide better support in meeting the counselling and mental health needs of young people, which includes those of young carers.

The Government are taking action across the board to meet some of the concerns to which my hon. Friend the Member for Hendon has rightly drawn attention. The position of young carers is a matter of very serious concern to the Government and, I am sure, to the House. It is tragic to see the life of a young person affected adversely by the assumption of very substantial caring responsibility. No hon. Member wants to see that happen. We are working very hard with local government, the NHS and others to ensure that we develop a more effective range of services to support young people who have those caring responsibilities.

I am sorry, to tell my hon. Friend the Member for Hendon that my hon. Friend the Member for Stalybridge and Hyde and I are not convinced that the right thing to do is to lower the age threshold to 14. For all the reasons given by my hon. Friend and the right hon. Member for Bromley and Chislehurst, and in the context of the Government's pursuit of our wider objectives, I think it would be wrong to make that change in the legislation.

I therefore hope that my hon. Friend the Member for Hendon will feel able to withdraw his amendment, not because we are turning our backs on young carers—we most definitely are not—but in recognition of the fact that, in the context of the Bill, the amendment would be counter-productive.

I think we are all singing from the same hymn sheet, although we are perhaps approaching the issue from different directions. I certainly agree with the point made by the right hon. Member for Bromley and Chislehurst (Mr. Forth)—I certainly would not want my amendment to be seen as sanctioning the practice of young people engaging in such caring activities. I was merely trying to recognise the sad reality that some children are in that position. I agree with all those who spoke in the debate that we have to try to address the issue within the bigger picture. I am also very grateful for the comments of my hon. Friend the Minister and my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry).

In moving my amendment, I have tried to put on the agenda the issue of young carers. However, I certainly take on board the point about direct payments, which is a valid argument against the amendment—there could be difficulties if people in that age group received potentially substantial sums. My objective was to raise the issue of identifying those young carers and empowering them to ask for assessments of their needs. However, as has been said, perhaps that issue could be better addressed as part of the general legislation to protect children.

In those circumstances, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

I beg to move amendment No. 2, in page 1, line 11, after "assessment", insert "within 42 days".

With this it will be convenient to discuss the following amendments: No. 4, in page 1, line 14, leave out "may" and insert "shall".

No. 5, in page 1, line 15, leave out—

', so far as it considers it to be material,'.

No. 8, in page 1, line 26, leave out "considers appropriate" and insert—

'shall agree with the carer'.

The amendments in this group are relatively straightforward, and I should be able to explain them relatively quickly. The purpose of the amendments is to tighten up clause 1 a little.

Amendment No. 2 provides that, if a local authority conducts an assessment at the request of a carer, it should do so within a fixed time limit, which I have suggested should be 42 days. I should think that six weeks is ample time for an assessment to be made. I am concerned that some, although by no means all, local authorities do not give the priority that they should to carers' issues, and that, without some type of time limit, the performance of an assessment could be delayed and end up on the back burner, so that carers who ask for an assessment could wait weeks or months for an assessment. I am sure that we have all heard of cases in which there have been such delays.

As statutory responsibilities have not been drawn sufficiently tightly, assessments are sometimes delayed. In amendment No. 2, I am simply trying to establish a time limit. Although I am not wedded to a 42-day time limit, I think it is reasonable to expect local authorities to conduct an assessment within six weeks. Nevertheless, I realise that, across the country, the ability of local authorities to perform such assessments will vary. I hope that, if 42 days is not acceptable to my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) and the Minister, they will propose an alternative time limit.

Although we all perfectly understand where the hon. Gentleman is coming from, there is one small point. He wants to ensure that the assessment occurs within a reasonable time. However, consultations that I have had with local authorities have exposed one problem, which is that the process can be delayed by the lack of medical information. I wonder whether the hon. Gentleman has taken account of that factor.

The hon. Lady has made an important and interesting point, and perhaps I could have improved the phrasing of my amendment by saying that the time limit would commence after the receipt of medical evidence from a general practitioner, consultant or other medical practitioner. It is a fair point.

Equally, it is important that we should establish a time frame in which the assessments should be performed. Although there may well be practical difficulties such as those she described, I am sure that we could establish a time scale that took account of those difficulties. If 42 days is not a practical time limit, I should be happy to consider alternative suggestions. Nevertheless, it is important to incorporate a time limit in the Bill.

Amendments Nos. 4 and 5 are related, and both are also an attempt to tighten up clause 1. Clause 1(2) mentions assessments under the Carers (Recognition and Services) Act 1995. The clause appears to leave it to the local authority to decide whether to take an assessment into account and suggests that it does not much matter either way. That is wrong. If an assessment has been conducted, it should be taken into account.

Amendment No. 4 would delete "may" and insert "shall". I am sorry that the right hon. Member for Penrith and The Border (Mr. Maclean) is not in his place, because when he was a Minister at the Home Office and I was a campaigning solicitor, we spent many happy hours in the law courts arguing about whether "may" meant "shall" and "shall" meant "may". The case ended up in the House of Lords, where I am pleased to say that I won the argument and he lost, at great expense to the then Conservative Government. Whenever I see the word "may" in legislation, I think that "shall" would be clearer.

Amendment No. 5 would delete the superfluous words

so far as it considers it to be material

because an assessment under the Carers (Recognition and Services) Act 1995 must be material to some extent.

Amendment No. 8 is not in my name, but I should like to mention it briefly, because empowering carers is important. This goes back to points that were made on a previous group of amendments about the need for carers to be involved at every stage of the process. We should not simply give local authorities what may amount to dictatorial powers to decree what people will get whether they like it or not. We must ensure that local authorities and carers work together—although I hesitate to go back to arguments about care plans—and try to involve carers more in agreeing a package of care and how assessments should be conducted, rather than simply leaving it to the discretion of the local authority.

My hon. Friend the Member for Hendon (Mr. Dismore) has already touched on some of the points that I wanted to make about my amendment No. 8. With the support and encouragement of the Government, local authorities are reaching out to carers and involving them in more than just consultation, which in many ways they have been involved in for years. Carers have played their part gallantly and, in addition to their caring responsibilities, have given their time, expertise and suggestions to local authorities. They have done that willingly, because they have felt that their contribution was important and valued. They hoped for an improvement in services not just for themselves, but for the person for whom they were caring. The well-being of the cared-for person is always paramount for carers.

Slowly but surely, carers are gaining a voice and saying that they, too, have needs and should be listened to. Consulting and involving people is not sufficient. We have already talked about partnership and empowerment. I endorse those concepts. If they are to be meaningful to the millions of carers in this country, my amendment should be accepted, because only then will they feel valued.

This is not about what carers want. It is about their agreement and involvement. We should make it clear to carers and to the local authority that conducts the assessment that it must be done in an atmosphere that involves the agreement of the person to whom the services will be supplied.

I am worried that the amendment that the hon. Member for Hendon (Mr. Dismore) tabled would make the Bill too prescriptive. I understand why the hon. Gentleman wants to include a time limit to ensure that the bureaucratic process does not take too long. However, as I said when we considered a previous group of amendments and, as my hon. Friend the Member for Meriden (Mrs. Spelman) pointed out, much depends on medical assessments.

Some cases in my constituency involve highly specialised medical assessments by consultants who are often in different parts of the country. Regrettably, those high falutin people take time to make their assessments. Although I sympathise with the desire of the hon. Member for Hendon to set a deadline to ensure that decisions are made, the bureaucratic process should not take over to such an extent that medical information is not available.

I have more sympathy for amendment No. 8, which the hon. Member for Halesowen and Rowley Regis (Mrs. Heal) tabled. Each case is different; that applies not only to each carer but to each person who is cared for. We cannot be prescriptive and issue a diktat from the centre to cover every case. I like the hon. Lady's wording:

shall agree with the carer.

The carer must be involved because no one is better qualified to analyse matters than those people whose lives are tied down 365 days a year to the details of cases: the family background, the physical circumstances, the medical conditions, the relationships with doctors and other people. Nobody knows that better than the carer.

I like the wording of amendment No. 8, but not that of amendment No. 2, which is too prescriptive and might lead to a lack of essential medical information.

I, too, support amendment No. 8, which the hon. Member for Halesowen and Rowley Regis (Mrs. Heal) tabled. In earlier debates, we considered the need to strike a balance between the carer and the disabled person. We also need to strike a balance between the strong power of the local authority as the assessor of the need and the person whose need it assesses. The amendment provides a useful opportunity to explore that a little further.

The balance is also relevant to the disabled person whose care needs are assessed and for whom a care plan is drawn up. Transparency and clear statements in the care plan are required so that plans can be challenged and the authorities that set them made accountable. A requirement for the process to have the carer's agreement is therefore sensible. However, perhaps the wording of amendment No. 8 will not achieve that, and I look forward to the response of the hon. Member for Stalybridge and Hyde (Mr. Pendry) and of the Minister. The spirit and intention of the amendment is worthy. Perhaps another form of words could be found to effect the amendment later in the Bill's passage.

I congratulate my hon. Friends the Members for Hendon (Mr. Dismore) and for Halesowen and Rowley Regis (Mrs. Heal) on the way in which they spoke about the amendments. They are caring amendments and I understand the spirit that lies behind them. I appreciate that my hon. Friends have tabled them because they support the Bill.

Amendment No. 2 would ensure that the benefits of carers assessment are secured as quickly as possible. We all support that. However, hon. Members have constituents who care for people who have refused an assessment. The amendment might not work in their best interests. The amendment would require authorities to be satisfied that a carer cares for a person for whom they provide or arrange the provision of services and to carry out an assessment "within 42 days" of the carer's ability to provide and to continue to provide.

I am sure that most hon. Members would acknowledge the need for local councils to ensure a speedy assessment and provision of services to support the carer. However, I support local discretion to ensure the highest quality outcome through the quality of the evidence on which decisions are made. I therefore ask my hon. Friend the Member for Hendon to withdraw the amendment.

On amendments Nos. 4 and 5, clause 1 gives informal carers of 16 and older who provide or intend to provide a substantial amount of care, the right on request to an assessment by the local council of their ability to provide and continue to provide care. Clause 1(2) allows a council to

take into account, so far as it considers it to be material,

any assessment that may have been made for the carer under the Carers (Recognition and Services) Act 1995.

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Clearly, when the information already held is up to date, it is in the best interests of both carer and council to allow the council discretion to take account of an assessment conducted under the 1995 Act. One reason is that flexibility is likely to speed up the delivery of services to carers; another is that it would be both bureaucratic and costly for councils to be required to undertake unnecessary additional assessments. The amendments would place a duty on councils to take into account the last assessment under section 1(1) of the 1995 Act, even if a carer's circumstances had changed since that assessment. That cannot be in the best interests of either carer or council.

I thank my hon. Friend the Member for Halesowen and Rowley Regis (Mrs. Heal) for tabling an amendment that would ensure that assessments were conducted in a way that encouraged the participation of carers. However, for two reasons, I ask my hon. Friend not to press the amendment to a Division. First, current guidance on good practice in the assessment of service users and carers is already clear: it states that participation in the assessment process is key. Secondly, my hon. Friend the Minister has assured me that the regulations that will be drafted to accompany the Bill will give local authorities a duty to ensure that such issues are discussed.

My hon. Friend the Member for Halesowen and Rowley Regis can rest assured that carers' involvement in their assessment is integral to the fabric of the Bill. Support for people who choose to be carers requires an understanding of how individual carers' roles affect them, and that can be ascertained only through a fully participatory assessment process. I hope that on that basis, too, my hon. Friend will not press her amendment to a Division.

It is clear to all of us—I know my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) agrees—that it is imperative for assessments to be made as quickly as possible. As always, the question is whether we want to create a statutory limit, and my hon. Friend has advanced some powerful arguments as to why that may not be the best option.

By means of several initiatives, we are trying to ensure that local authorities carry out assessments quickly. We have already done two things. My hon. Friend the Member for Harrow, West (Mr. Thomas) mentioned the performance assessment framework. As part of our drive to improve the performance of social services departments, we have established key indicators to determine whether authorities are providing services effectively and efficiently. There are 35 indicators, but there will soon be 50.

A number of the indicators relate to how effectively authorities are delivering services to carers. One relates specifically to how quickly carers receive help. The performance assessment framework, and the performance of authorities judged against it, will inform the use of the best-value powers taken by the Government under the Local Government Act 1999. We will not tolerate poor performance; we will not tolerate circumstances in which carers' needs are not assessed quickly and efficiently. If we tolerated those things, we would sanction not just poor practice but ineffective service. There is no doubt that support for carers will be better as a result of consultation and involvement with users, and will be better if it is provided as quickly as possible. My hon. Friend the Member for Stalybridge and Hyde was right to draw the attention of my hon. Friend the Member for Halesowen and Rowley Regis (Mrs. Heal) to commitments we gave in Committee that we will ensure that guidance and practice notes issued in the context of this legislation will emphasise the importance of good practice, including involving and consulting carers in the assessments. I make that commitment again today, and the guidance will have statutory effect under section 7 of the Local Authority Social Services Act 1970.

The Minister is giving an important explanation of how the legislation will work in practice. Is there any system of penalties if, as the Minister suggested, the Government can no longer tolerate the actions of a local authority in relation to the indicators?

Yes, and those new powers are contained in the Local Government Act 1999. If there is a serious and persistent failure on the part of the local authority to deliver effective social services to its local community, the Government have a range of measures that they can use to ensure that performance is corrected. We will not hesitate to use those powers if that is the right thing to do. So a remedy is available, but we wish to promote and encourage good practice by local authorities in several ways. One way is through the development of new local charters in relation to the "Better Care, Higher Standards" programme, now under way, under which local authorities will fix their own local charters in relation to performance in social services and related areas. That, too, will help to ensure that local authority performance is improved. It will be improved primarily because carers will have access, at a local level, to the information contained in the charters and will be aware of what buttons they need to press to ensure that the services are delivered appropriately and promptly.

My hon. Friend the Member for Stalybridge and Hyde also referred to amendments Nos. 4 and 5. If we were to incorporate those provisions, we would do a substantial disservice to carers, because the effect of accepting the amendments would be to place a duty on local councillors to take account of the last carers assessment under section 1 of the Carers (Recognition and Services) Act 1995, even if the circumstances of the carer and/or the person being cared for had changed since that assessment was carried out. There is no logic in tying the hands of the local authority to an out-of-date assessment. I am sure that my hon. Friend the Member for Hendon would accept that.

Like my hon. Friend the Member for Stalybridge and Hyde, I have come to the conclusion that the amendments should not be accepted. They would not improve the Bill and I hope that my hon. Friend the Member for Hendon will withdraw them.

I have listened closely to the cogent arguments put forward by my hon. Friends the Minister and the Member for Stalybridge and Hyde (Mr. Pendry) and I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

I call Mr. Pendry to move the next amendment.

I thought that the amendment stood in the name of my hon. Friend the Member for Halesowen and Rowley Regis (Mrs. Heal).

The amendment stands in the names of three Members, and as the hon. Gentleman's is the first, and as he is the promoter of the Bill, I did him the courtesy of calling him. However, I now call the hon. Member for Halesowen and Rowley Regis instead.

I beg to move amendment No. 38, in page 1, line 17, leave out "carer" and insert "individual".

This is a small but practical amendment, and it is close to the hearts of many carers. The amendment has two purposes. First, it would ensure consistency with the Carers (Recognition and Services) Act 1995. Secondly, it would narrow the definition of a carer.

Clause 1(3) is similar to the provision in the 1995 Act in that it ensures that only informal carers will have access to the rights in the Bill. Specifically, the Act states that anyone who undertakes care as part of their employment or as a volunteer cannot access those rights. The current drafting of the Bill differs in one respect from the previous Act in that it uses the word "carer" in the first line of the subsection rather than the term "individual". The first purpose of the amendment, therefore, is to ensure that the Bill is consistent with the carers Act by changing the word "carer" to the word "individual" in line 17.

The amendment's second purpose is to ensure consistency of definition. Using the word "carer" automatically suggests that the two groups not entitled to the provisions under the Bill could be considered to be carers in other circumstances. The two groups are people who are employed as care assistants and those who provide care as volunteers.

This is a relatively minor amendment, but it is very important philosophically. No legislation other than the 1995 Act refers to a "carer". The National Health Service and Community Care Act 1990 refers to private carers, and the Disabled Persons (Services, Consultation and Representation) Act 1986 refers to carers by describing the activities that they perform. The Care Standards Bill, which is concerned with regulating care assistants, does not use the term "carer" to mean people who are employed. Instead, it uses the term "social care worker".

As the rest of the clause mirrors the wording in the 1995 Act where appropriate, it seems that this is a minor drafting oversight. I have no doubt that other hon. Members who are involved with carers in their constituencies are also aware that carers feel very strongly about protecting the definition of a carer. The Carers National Association, which firmly backs the amendment, agrees with my view, as does my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) and I am pleased that we have an assurance from the Minister that he too will support it.

Some people do not like labels, but carers who are happy to be labelled as such become very distressed when other groups of people, such as care assistants and care workers, are labelled as carers. That is not because they do not value the work of those who are paid carers, but because they value what the term carer means to them and their families. It is a recognition of the role that they play and the work that they do, albeit unpaid.

Of course, colloquially, many people continue to refer to care assistants as carers. The amendment will not change that, but it will keep the legal definition as simple and consistent as possible. That would also be desirable as community care law is already so complex. I propose therefore that we consider this simple and practical amendment.

Thank you, Sir Alan, for giving me pole position in relation to the amendment, but as the diligence and persistence of my hon. Friend the Member for Halesowen and Rowley Regis persuaded the Minister and me to go along with it, I thought that she should have the opportunity to shine. I am grateful to her for that. The amendment would clarify further the distinction between informal carers, who provide or intend to provide a substantial amount of care on a regular basis, and care workers and volunteers.

It would be wrong for the Bill to use the term "carer" loosely to include care workers and volunteers, although I accept that that is standard parlance. I am sure that the Minister will want to respond to the amendment, so having said those few words, I congratulate my hon. Friend.

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The amendment would safeguard the definition of a carer and make clearer the distinction between an informal carer who cares for a relative or friend, and a paid care worker or volunteer. The amendment would certainly strengthen the definition, and the Government are happy to support it. I urge the House to accept it.

Amendment agreed to.

I beg to move amendment No. 9, in page 2, line 2, at end add

'and "volunteer" means somebody who may receive out of pocket expenses but not paid remuneration in relation to caring responsibilities.'.

My comments on the amendment need only be brief, as it follows from what I said on amendment No. 38. I want the Bill to make it clear that volunteers helping family members with their caring responsibilities could receive help towards any expenses, such as travel expenses, that might be incurred. Such volunteers would not receive paid remuneration under the Bill, but the amendment would ensure that they could receive help with out-of-pocket expenses.

I understand why my hon. Friend has tabled the amendment, but I can reassure her that subsections (3)(a), (3)(b) and (6) of clause 1 mirror parts of the Carers (Recognition and Services) Act 1995, which has never caused the confusion that she has envisaged. The adoption of the language of the 1995 Act is a good thing in its own right, but it also ensures the smooth working of the dual regimes in social service provision for which that Act provided. For those reasons, I hope that my hon. Friend will withdraw the amendment.

I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 2

Services For Carers

I beg to move amendment No. 39, in page 2, line 18, after "services", insert—

and they both agree it is to be so delivered'.

With this it will be convenient to discuss the following amendments: No. 15, in page 2, line 20, at end insert—

'without the consent of the person cared for'.

No. 37, in page 2, line 20, at end insert—

'(3A) A service cannot be provided to a carer where it could otherwise be provided to the person cared for if it—
(a) is one which could fall within community care services; and
(b) is one that the person cared for does not object to receiving as a community care service provided to him.'.

Amendment No. 39 stands in the names of my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) and my right hon. Friend the Secretary of State. However, Mr. Deputy Speaker, you have only just taken charge of our proceedings and may not be aware that my hon. Friend is suffering from the effects of illness. As I explained to Madam Speaker earlier, I am, with my hon. Friend's agreement, happy to take the load off his shoulders in moving this amendment.

I shall begin by explaining some of the background to the amendment, which is probably one of the most important selected for debate today. If the House accepts it, it will strengthen the Bill significantly. In discussions with carers organisations, my hon. Friend the Member for Stalybridge and Hyde and I identified the need to reassure people that a carer and the person cared for must both agree in cases where a service is provided to the carer but is delivered to the cared-for person. The fact that two other amendments that touch on that point have been tabled by hon. Members highlights the concern about that issue.

The amendment would make it explicit in the Bill that agreement needs to be obtained in the cases I have described. To ensure that the balance of the Bill is retained, the amendment covers both the carer and the cared-for person. It provides that the carer must agree to having the service provided, and the cared-for person must agree to the service being delivered. I am pleased to say that the amendment now has the support of the Carers National Association.

I take this opportunity to repeat assurances given in Committee that if the Bill receives Royal Assent, the Government will issue guidance to local councils under section 7 of the Local Authority Social Services Act 1970. That will cover the use of this new flexibility, so that it does not compromise or put at risk the position of the carer or the cared-for person. I hope that my hon. Friend the Member for Harrow, West (Mr. Thomas) and the hon. Member for Sutton and Cheam (Mr. Burstow) are reassured by amendment No. 39 and so will not move their own amendments, but support this one.

Clause 2(3) was never intended to operate as a sort of sleight-of-hand under which carers could be double-charged for services delivered to the cared-for person. I hope that amendment No. 39, together with amendment No. 33, which we shall come to later, will put to rest any such concerns.

I am grateful to the hon. Member for Sutton and Cheam for his amendment No. 37 on this general area. I fully understand the point that he and the hon. Member for St. Ives (Mr. George) are making. I think, however, that amendment No. 39 deals with their concerns in a better way, because it emphasises the need for both the carer and the cared-for person to agree to the services being delivered to the cared-for person. Both parties should be fully satisfied about the way in which services are to be delivered. This is the fair way to proceed in what is, by common consent, a sensitive area. The amendment will ensure that that happens. It will ensure that clause 2(3) will have the effect that we always intended it to have, but will allow us to retain the flexibility for services to be delivered in the most sensible way possible.

Amendment No. 39, together with amendment No. 33, will, I hope, deal with the very genuine concerns expressed by hon. Members and carers organisations that carers might be treated unfairly as a result of the way in which clause 2(3) and clause 4 have been drafted. My hon. Friend the Member for Stalybridge and Hyde has been determined to avoid any such outcome, and I am pleased that he has taken the initiative in putting matters straight. I hope, therefore, that the House will support amendment No. 39 and that the other two amendments in the group will not be pressed.

I wish to speak briefly to the amendment in my name, although I should say at the set that I will probably not press it, for the very good reasons that the Minister has given. However, it provides me with an opportunity to revisit one or two points that were explored in some detail in Committee.

The Minister gave a very welcome indication in Committee on 8 March that he and the hon. Member for Stalybridge and Hyde (Mr. Pendry) were minded to bring forward an amendment on Report. Although I am not entirely comfortable with the precise drafting of the amendment, I think that, by and large, it addresses the concern that the Bill as it stands unintentionally creates a loophole, and that some local authorities might decide to drive a coach and horses through it to redefine particular services in such a way as to shift the financial burden from one party to the other. As the Minister has said, that is not the Government's intention. It is in that context that my amendment was tabled.

We have discussed several times today the need to be sensitive to the balance of interests between the disabled or cared-for person and the carer. I am strongly of the view that we must be mindful of the need to promote independence for the disabled person within that relationship wherever possible. That is one area in which my amendment attempted to give the final deciding influence and interest to the disabled person. Amendment No. 39 does at least give both parties a say. Although I still think that it would be better to give a signal that we want to empower and promote independence for the disabled person, the Minister's arguments go a very long way to meeting the concerns that were expressed outside the House and which I and other hon. Members raised in Committee.

I shall not press my amendment because the Minister has clearly presented his case.

We sought this important amendment after the Committee stage because everyone saw a loophole in the Bill as originally drafted. I remain concerned, however, that a problem remains, which was in fact the birthplace of the Bill. We want to deal with the problem where carers and those for whom they care have to come to an agreement about the help provided—when no agreement is reached, the carer sometimes becomes short. The amendment improves matters but, sadly, breakdowns in communications happen. In Committee, we heard of families where there is strain between the carer and the cared-for person simply because of the pressure involved in looking after someone with a disability. Relations can break down and agreement may be lacking. I ask the Minister to discuss that scenario in his reply.

In its most recent briefing, the Carers National Association remained concerned that the loophole may still exist. It would be possible for a local authority to identify a service such as transport to and from a day care centre as one that benefits the carer. The respite bought for a carer when a disabled child can go to a day care centre is valuable, but the danger remains that the carer may fall into a gap through lack of agreement or because local authorities seek to limit costs in providing assessed needs. Will the Minister assure us that one set of interests will not be played off against the other?

The boundaries that must be drawn between services and a support to the carer and to the cared-for person are difficult. There is a danger that the boundaries will become too blurred. Although the amendment improves matters, I want to be sure that scope remains for achieving the optimum solution for the carer and the cared-for person.

I apologise for not having been present at the start of this debate. I want to speak briefly to my amendment No. 15. It is a probing amendment, so I do not intend to push it to a vote. It expresses concern from the Carers National Association about use of the word "intimate". The association's briefing points out that as intimate services are not defined, it is difficult to explore the scope of the provision.

I am concerned that services such as bathing, which may be offered to a disabled person to make the carer's life easier, might be unintentionally excluded from the Bill. My amendment would allow such services to be provided with the consent of the person being cared for. I ask my hon. Friend the Minister to clarify the Bill's intentions.

12.45 pm

The debate has been useful, and I shall address some of the remaining concerns about this aspect of the Bill. During our debates on Second Reading and in Committee, we tried to explain why we had drawn up clause 2(3) as we did. It was designed to give local authorities extra flexibility in the provision of services to carers. As I pointed out when I moved the amendment, the provision was never intended to be a camouflage—some device through which local authorities could mysteriously move the charging obligation for services either for the carer or for the cared-for person. Concerns were raised about that matter, so the amendment was tabled to put it beyond doubt.

Although amendment No. 39 is not grouped with amendment No. 33, hon. Members will realise that both are an attempt to deal with the issue. They make it clear that we were not inadvertently constructing a device that would, in effect, penalise carers if services delivered to the cared-for person were actually provided to the carer. I hope that the amendment will command the support of the House. It attempts to put the matter beyond reasonable doubt.

The hon. Member for Meriden (Mrs. Spelman) referred to consent—agreement between the cared-for person and the carer. When I moved the amendment, I made it clear—as my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) would have done had his voice been with him—that the matter is sensitive. We cannot force people to accept services against their will. That would be intolerable for both the carer and the cared—for person, especially in regard to some of the services that would be covered by that provision-those of an intimate nature. To ensure that the consent of both parties is specified will be an important clarification of the clause.

The hon. Lady is right to point out that in some cases there may be no agreement between the carer and the cared-for person about the services delivered to the carer. However, I suspect that that is a fact of life. Such problems have always been with us; the Bill has not manufactured them out of thin air.

That is the dilemma that the Bill was introduced to solve. If the cared-for person does not give consent to an assessment of their needs, the Bill unlocks the gate so that the carer can be assessed too. We have now slightly shifted downstream the point at which such conflict might arise. Can the Department give strong and clear guidance to local authorities to assist them in dealing with those sensitive issues and relationships?

I shall say something about that issue in a moment, if the hon. Gentleman will bear with me. He is right to trace the history of the measure and the problem that it tried to resolve. However, the matter that he highlights is addressed in another part of the Bill.

The measure will allow services to be provided directly to the carer, notwithstanding the fact that the cared-for person has refused a community care assessment under the National Health Service and Community Care Act 1990. Those services can be provided directly to the carer. We are talking about services that could be described as "either way"—they could be offered to the carer or to the cared-for person. The background to clause 2(3) was an attempt to give local authorities greater flexibility in designating their services, so that services could go to the cared-for person via the carer if that was convenient to both parties.

That was always the intention of that provision. It was never intended to be some careful device, cooked up by others, to allow local authorities, under their charging policies, to recover more from service users. That was never the purpose. My hon. Friend the Member for Stalybridge and Hyde has always made it clear that that was his view. In a Bill designed to empower and enable carers to receive better support, neither he nor I would support a provision that would knock them back to a situation in which they were unfairly treated or compromised financially. We shall not do that; that is why we tabled the amendment.

On the point that the hon. Member for Sutton and Cheam has just raised about local authorities, new flexibilities under clause 2(3), I tried to spell out in my opening remarks—I am happy to do so again—that we certainly intend to issue guidance, which I remind the House will have statutory effect under section 7 of the Local Authority Social Services Act 1970, on how local authorities may use such flexibilities, so double protection is built in. Amendment No. 39 will make it clear that the consent of both parties is needed, and we have the back-up of the force of section 7 statutory guidance.

Through this amendment, together with amendments that we shall debate in a minute, we have been anxious—my hon. Friend the Member for Stalybridge and Hyde has been so particularly—to ensure that the Bill reflects the perfectly fair and reasonable concerns that have been expressed. We recognised the potential for the sort of circumstances to which hon. Members have referred on Second Reading and in Committee, and believe that amendments Nos. 39 and 33 will lay such concerns to rest. The Bill's original intentions can be reconfirmed and clarified, and we can move on.

Amendment agreed to.

Clause 3

Vouchers

I beg to move amendment No. 36, in page 2, line 27, after 'services', insert—

'in lieu of the care'.

Clause 3 makes provision for the issuing of vouchers for the taking of short-term breaks. All hon. Members will recognise the importance of respite care and that the provision of vouchers is one of the Bill's fundamental principles. I introduced a ten-minute Bill on respite care—short-term breaks is now the preferred term—a couple of years ago.

It is important to clarify the relationship between carers and the cared-for person. The amendment is necessary to ensure that there is no change in that relationship. Carers care out of duty and love. As drafted, the clause suggests that carers provide "services". We would normally expect such services to be provided under a contractual relationship by an outside body, such as a local authority, the health service or a voluntary organisation. It is slightly problematic to regard the relationship between the carer and the cared-for person as one in which the carer provides services.

The amendment would formalise the relationship, which is essentially based on love and duty. Any of us who have known the relationship—I well recall my mother having to care for her elderly mother for several years—know that carers are not providing direct services but serving out of love and duty.

The term "services" implies that there might be entitlements and that there will be standards and a claim on the carer, which I am sure hon. Members would regard as inappropriate. I therefore ask the House to accept the amendment in order to ensure the maintenance of the status quo in the relationship between the carer and the cared-for person. I believe that the Government will agree that the amendment is in the spirit of the Bill, and I hope that my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) is able to accept to it.

I added my name to the amendment for many of the reasons that the hon. Member for Monmouth (Mr. Edwards) has just described. When we are attempting to support family and caring relationships, we should not try to formalise them under service provision. The Bill poses such a danger. The hon. Gentleman is right to have highlighted that by tabling the amendment. I hope that in response to the debate, we shall hear how such a downside could be avoided.

We are about recognising and valuing carers, and ensuring that their needs are assessed at an early opportunity and that they receive the services that they need to be able to fulfil the caring responsibility that they have taken on. To turn the relationship into a contractual one is entirely wrong and we should attempt to avoid the Bill giving that signal. I hope that the hon. Member for Stalybridge and Hyde (Mr. Pendry) can reassure us on that. If the amendment will not achieve our aim, I hope that something will be done at a later stage to give effect to our intention.

I am grateful to hon. Members for their suggestion. We had a Conservative-Labour alliance earlier and now there is a Lib-Lab alliance—perhaps that is the way forward.

I am grateful for this helpful amendment. It serves to highlight the distinction between the support that informal carers provide and the sort of services provided by health and social services and other service providers. Service providers must see carers as partners in the provision of help to the persons needing support and must involve them as partners. However, as the amendment suggests, it would be unhelpful to view the help provided by informal carers in exactly the same light as services provided formally by statutory or voluntary providers.

Most caring is founded on close personal relationships. Sensitive and effective support for the people who choose to be carers involves understanding the unique impact of each carer on his or her caring role, as well as acknowledging the vast contribution that carers make to society as a whole.

Both contributions on the amendment were short. I shall be short in saying that I hope that the House will accept the amendment.

Amendment agreed to.

Clause 4

Assessments And Services For Both Carer And Personcared For

Amendments made: No. 29, in page 2, line 42, leave out "(1)" and insert "(2)".

No. 30, in page 2, line 43, leave out "(1A)" and insert "(2A)".

No. 31, in page 2, line 43, leave out "such an assessment" and insert—

'an assessment under subsection (1) or (2)'.

No. 32, in page 3, line 1, after "1", insert—

'or (Assessments: parents of disabled children)'.—[Mr. Hutton.]

I beg to move amendment No. 33, in page 3, line 27, at end insert—

'( ) The local authority's decision under subsection (4) is to be made without regard to the means of the carer or of the person cared for.'.

With this it will be convenient to discuss amendment No. 48, in page 3, line 27, at end insert—

'( ) The decision of the local authority under subsection (4) is to be made taking full account of the means of the carer or person cared for and determined appropriately.'.

May I clarify, Mr. Deputy Speaker, whether we are also discussing amendment No. 34?

We are discussing amendment No. 33. If it is of any help to the Minister, may I point out that we shall deal with amendment No. 34 after this group? We are now on amendment No. 33.

Thank you, Mr. Deputy Speaker.

After discussion with my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) and in recognition of the fact that he is losing his voice, he is happy for me to move this amendment which stands in his name and that of my right hon. Friend the Secretary of State for Health.

During the first sitting of the Committee, my hon. Friend referred to a meeting that he and I had with representatives of carers and persons with parental responsibility for disabled children. One of the matters discussed was the concern to ensure that an opportunity is not created for councils to take account of who is best able to pay a charge when deciding whether to provide services as carer services under the Bill or as community care services under the National Health Service and Community Care Act 1990.

It was recognised that such an opportunity could in theory arise because the Bill offers the fullest flexibility to councils in the services that they may offer carers to ensure that the actual needs of individual carers are properly met. To tackle that point, the hon. Member for Sutton and Cheam (Mr. Burstow) tabled his elegant solution to the problem in the second sitting of Committee. His amendment forms the foundation of the amendment that I move today.

Amendment No. 33 will add a new subsection to clause so that it becomes possible to ensure that decisions made by councils about whether a service can be provided to the carer as a carer service or to the cared-for person as a community care service do not take account of the financial resources of the individuals concerned.

I am afraid that amendment No. 48, to which the right hon. Member for Bromley and Chislehurst (Mr. Forth) will speak shortly, has the opposite effect. It is entirely contrary to Government policy on social care. Let me explain to him why. We have already discussed the matter in part in relation to an earlier amendment, when he asked whether resources should be taken into account when needs are assessed or when liability to a charge is assessed.

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Councils' decisions about an individual's eligibility for community care services must be based on an assessment of their needs. The financial assessment of individuals as part of a council's charging policy is a subsequent step in the process. The level of people's resources should not, however, alter the assessment of the sort of help that they need with everyday tasks.

Amendment No. 33 is therefore entirely consistent with our policy. Once again, we have listened to carers and people with parental responsibility for disabled children. We are taking action—indeed, my hon. Friend the Member for Stalybridge and Hyde has already done so—to ensure that the Bill addresses their concerns. I therefore urge the House to accept amendment No. 33, but I strongly urge it to reject amendment No. 48.

I am the first to concede that, almost certainly, this is not an appropriate time to have a full-blown debate about what is crudely known as means testing. However, I do not want the occasion to pass without at the very least making a nod in the direction of the argument, as I have been bothered by the matter for some time. We need to return to the matter from time to time to ensure that we are all happy about where we are going.

Section 17(8) of the Children Act 1989 states:

Before giving any assistance or imposing any conditions, a local authority shall have regard to the means of the child concerned and of each of his parents.

Amendment No. 48 very much reflects the spirit of that. I make no apology for offering an argument made since the invention of the welfare state, and asking whether it is right or sensible to deliver a taxpayer-funded service to people who are well able to provide for that service themselves or for those for whom they have taken responsibility. That is an old argument covering familiar territory which, none the less, is relevant in the context of the Bill.

I therefore wish to ask the Bill's promoter and the Minister whether they are still satisfied that it is a proper and correct use of taxpayer-funded resources, services, personnel and so on to support people who are patently and demonstrably well able to look after themselves financially. I have always thought that that was the wrong way to go, and—if I can put it this way—have always been a means tester. I have always thought that taxpayers' money should be properly focused and directed at those who can demonstrate that they need such assistance.

I am therefore opposed to blanket provision, whenever it arises. I have always thought that giving taxpayers' money for whatever purpose—however laudable or justifiable—to everyone, regardless of their means, is absurd. We all know of people who are elderly or, as in this case, disabled, who have considerable resources. It looks odd to ordinary taxpayers if their money is channelled through taxation to provide services or benefits to such people who are much better off than them.

We are obliged to return frequently to that question, if only to reassert the view—which the Government take and which has been expressed today by the Minister—that it is perfectly proper to tax those who are not well off and give that money to people who are much better off than those taxpayers. It is difficult to defend that principle. Of course, I accept that my argument implies a certain degree of bureaucracy and intrusion—questions may need to be asked, and many people may find that unpalatable or unacceptable. However, to my mind, the greater good, or the greater justification, lies with those who say that we are entitled to ask before we part with taxpayers' money—either directly in the form of money, grants or whatever, or in the form of services and support—whether that person really needs that support, or is perfectly capable of looking after themselves in a financial sense. That is the question that I seek to pose in amendment No. 48.

I do not wish to divide the House on the matter at this stage. It would be inappropriate in the context of the Bill, but I would like to hear the promoter or the Minister say again, however briefly, why they believe that having no interest in the means of the person to whom the assistance is given remains the correct approach.

As I understand it—indeed, we explored the matter in Committee—it is not a matter of not assessing means at all; it is a question of the sequence in which means are assessed. In that sense, the question is, who is the gatekeeper? What is the gateway through which the person travels?

Is it a gateway to assess the person's financial means, which the amendment of the right hon. Member for Bromley and Chislehurst (Mr. Forth) appears to describe, or is the gateway to assess a person's need for care? Once they have passed through the gateway to assess their need for care, there is an entirely legitimate debate to be had about assessing their financial means and the scale of charges that might be applicable for the provision of particular social care services.

I do not see how the amendment that has been tabled by the hon. Member for Stalybridge and Hyde (Mr. Pendry), or, indeed, the amendment that I tabled in Standing Committee, would invalidate the points that the right hon. Gentleman has made, but he usefully raises the question of means testing and whether provision of a free service, with no charge levied, may disproportionately benefit the better off.

That is a live and current issue in the context of the royal commission on long-term care. It seems that it reported a lifetime ago, but it was just at the beginning of last year. It is to be hoped that the Government will imminently give their final, determined view on its report; it is expected in July. Let us hope that it is their final statement and position on the matter.

That will bring into sharp relief the issue that the right hon. Gentleman has mentioned, but I do not think that that debate is relevant to the debate on these amendments, which is simply about the proper sequence in which those matters should be looked at. In my judgment, it makes sense to start by looking at the care needs of the person before considering their financial needs.

That is what the amendment that I moved in Committee sought to do. As I understand it, it is the purpose of amendment No. 33. I will support that amendment because it provides welcome clarification. It will reassure many outside the Hous—it will certainly reassure the Carers National Association and many carers, too.

From my own recent case work, I know that the introduction of charges and means tests is a cause of great anxiety and concern for carers. Only two weeks ago, I attended a meeting of my carers forum in Sutton, where the issue was explored in great detail because my local authority is considering extending charging to daycare services—a controversial proposal, although not unusual in many other local authorities, which already operate such charges. Nevertheless, carers and those whom they care for are very concerned. Therefore, it is right that the amendment clarifies that the need should be checked and assessed before the means are assessed. I support the amendment and hope that the House will do so, too.

I shall speak briefly, partly to do a bit of bridge building between the amendments which in many ways address different things. Throughout the Committee stage, members on both sides pressed for a distinction to be made between the process of needs assessment and that of financial assessment, so that one follows the other. The Committee was quite clear that there must be integrity in needs assessment.

I think, however, that my right hon. Friend the Member for Bromley and Chislehurst (Mr. Forth) made a very good point, in relation to which I may be able to provide a good practical illustration. As newspapers often, even daily, report, courts are awarding very substantial sums to the parents of disabled children when medical negligence, for example, has been proved. Although, sadly, it often takes a very long time to establish that there has been negligence and to calculate damages, when the damages are calculated, I believe—I am not a lawyer, but the Minister is—that, in assessing them, the court will take into account the disabled child's care costs.

I therefore believe that my right hon. Friend made a good point. If a judicial assessment has been made and damages awarded, it would be quite legitimate for the local authority to make its case that, in awarding damages, the court had already recognised that quite considerable public sums are required to support the family of the disabled person. It could therefore be quite strongly argued that that award should be part of the financial assessment.

The hon. Member for Meriden (Mrs. Spelman) attempted to build a bridge between amendment No. 33 and amendment No. 48. She will be lucky if she succeeds in doing so, as the amendments are diametrically opposed and would have completely opposite effects. Amendment No. 48 would effectively ensure that a means test was applied, not when assessing liability to a charge but when assessing even whether a person should benefit at all from a service. In view of the alleged compassionate conservatism being proclaimed by Conservative Members, the hon. Lady may not wish to adopt that policy.

All hon. Members who have spoke have, in one way or another, raised the issue of charging for social services. The hon. Member for Sutton and Cheam (Mr. Burstow)—as he is wont to do on such occasions—mentioned the royal commission's very important report. As he said, the Government will in the summer announce how we hope to achieve our objectives in relation to social services charging for non-residential care, to build greater equity and fairness into the system and reduce the scale of variation between local authorities in charging policy.

We are also awaiting with interest the publication of the Audit Commission's imminent report, which I am sure will throw some light on and provide valuable insights into the exact nature of the problem that we have to deal with and the precise scope of variations in charging regimes. I think that those variations are substantial, and that we shall have to take effective action to reduce them. The variations can have the type of effect mentioned by the hon. Member for Sutton and Cheam. However, that debate is for another occasion.

I should like simply to reassure the House about the purpose of amendment No. 33. The amendment is intended to ensure that councils do not consider the potential for raising charge income in deciding who—whether a carer or the cared-for person—should receive a service. In doing that, we are trying to proceed sensitively and carefully.

Amendment No. 33 ensures that in offering councils the fullest flexibility in determining the services that they may offer carers under the Bill, an opportunity is not created for councils to take account of who is best able to pay a charge when assessing need. The amendment therefore deals with users' and carers' valid concern that councils should not consider the potential for raising charge income when deciding who should receive a service.

The example that has been given—it is a perfectly fair one—is the case of a cared-for person who is not liable for a charge, and has been so assessed, but in which the carer may be liable for a charge. If the services are delivered by the council as a carer service, there will therefore be the possibility of shifting the caring burden on to the carer. Amendment No. 33 is designed to prevent precisely that from happening and to address that important issue. A valid concern has been identified, and my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) has tried very hard to deal with it. I think that we have done that entirely properly in amendment No. 33. The House should accept it, and confidently reject amendment No. 48.

Amendment agreed to.

Clause 5

Direct Payments

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I beg to move amendment No. 34, in page 3, line 33, leave out "and" and insert—

'( ) for paragraph (b), substitute—
"(b) in the case of a person—
(i) whose needs the local authority have decided call for the provision of community care services, he is of a description which is specified for the purposes of this subsection by regulations made by the Secretary of State, or
(ii) whom the local authority have decided to provide with services under the Carers and Disabled Children Act 2000, he is not of a description so specified by regulations made by the Secretary of State,"; and'.

Section 1(1) of the Community Care (Direct Payments) Act 1996—a pioneering piece of social care policy introduced by the previous Administration, for which we give them credit—provides for regulations to be made specifying the persons who may receive direct payments. We have made such regulations. Only those persons specified in the regulations are eligible for direct payments.

The position is different for carers. The policy intention is that all carers assessed as needing carers' services under the Bill should be eligible for direct payments. We have taken a power to exclude certain descriptions of carers in regulations to ensure flexibility should particular circumstances arise.

The amendment would allow local councils to make direct payments to all carers who have been assessed as needing carers' services, unless they are excluded because they are of a description specified in regulations. I urge the House to accept this important technical amendment.

Amendment agreed to.

Clause 6

Vouchers, And Direct Payments To Disabled Childrenand Parents Of Disabled Children

I beg to move amendment No. 40, in page 3, line 40, after "as", insert—

', subject to subsections (5) and (6),'.

With this it will be convenient to discuss the following amendments: No. 23, in page 4, line 10, at end insert—

'( ) The Secretary of State may issue guidance to local authorities as to the exercise of their discretion under subsection (1).'.

No. 42, in page 4, line 11, after "(5)", insert—

'Except as mentioned in subsection (6) of this section,'.

No. 43, in page 4, line 21, at end insert—

'(6) Section 1(2) of the Community Care (Direct Payments) Act 1996 does not apply in relation to payments under subsection (1) to—
(a) a person with parental responsibility for a disabled child, other than a parent of such a child under the age of sixteen, in respect of a service which would otherwise have been provided for the child; or
(b) any person who is in receipt of income support, working families' tax credit or disabled person's tax credit under Part VII of the Social Security Contributions and Benefits Act 1992 or of an income—based jobseeker's allowance,
and in those cases the amount of any payment under subsection (1) is to be at a rate equal to the local authority's estimate of the reasonable cost of securing the provision of the service concerned.'.

I am sure that my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) would have liked to move the amendment—or at least I think he would—if his voice had been strong enough to allow him, but my right hon. Friend the Secretary of State and I are happy to support it.

New section 17A(5) would apply section 1(2) of the Community Care (Direct Payments) Act 1996 to direct payments made under the Children Act 1989. Under the 1996 Act, a local authority can have regard to an individual's financial circumstances when determining the amount of a direct payment. However, an individual cannot be required to contribute more than they can afford. Amendments Nos. 40, 42 and 43 minor the charging arrangements in section 29 of the Children Act 1989, so that the position will be the same for all service users, whether they opt to receive services, direct payments or the new vouchers. We have always made it clear that there should be no financial incentive—or disincentive—to choose one option over another. Our aim has been to create a level playing field.

Amendment No. 43 is the substantial amendment in the group. Section 29 of the Children Act 1989 sets out the recoupment provisions in respect of services. It allows for the recovery of charges from parents and not others with parental responsibility. It also exempts certain low-income families from paying parental contributions. Subsection (6)(a), which would be inserted by amendment No. 43, minors for direct payments the charging regime in section 29 of the Children Act 1989. Subsection (6)(b) would exempt those who receive income support, working families tax credit, disabled persons tax credit or an income-based jobseeker's allowance. The subsection would ensure that direct payments made by families covered in those two paragraphs were at a rate equal to the local authority's estimate of the cost of securing the provision of those services.

I strongly believe that it is right that low-income groups should be exempted. We recognise that families with disabled children face increased costs in bringing up those children and that it is harder for parents with disabled children to play their full part in the world of work. It is important that those families under stress who come to social services seeking relief from that stress are not faced with extra expenses that they would struggle to meet.

I should like to add that, at the moment, the amounts collected for children's services by local authorities through parental contributions are small. In the majority of cases, local authorities make a nil assessment. In others, the cost of collecting a small parental contribution is more than its financial value.

In community care, recouping costs through charging service users does not constitute a significant proportion of the revenue available for children's services. The arrangements that the amendments propose will have a neutral effect on local authority finances. I therefore commend the amendments as sensible, fair to service users and entirely consistent with existing arrangements under the Children Act 1989.

Amendment No. 23, which has been tabled by my hon. Friend the Member for Hastings and Rye (Mr. Foster), is unnecessary because section 7 of the Local Authority Social Services Act 1970 provides for local authorities to act under the Secretary of State's general guidance. As I said in Committee, guidance will be issued to local authorities to help them to undertake the new responsibilities that the Bill imposes on them. I have given a commitment to work closely with carers groups and voluntary organisations in preparing the guidance.

I hope that my hon. Friend will recognise that there is no difference between us on the need for guidance and for consultation on it. His intentions will be realised without amendment No. 23.

Amendment agreed to.

Amendments made: No. 41, in page 3, line 44, leave out "parent of" and insert—

'person with parental responsibility for'.

No. 42, in page 4, line 11, after "(5)", insert—

'Except as mentioned in subsection (6) of this section,'.

No. 43, in page 4, line 21, at end insert—

'(6) Section 1(2) of the Community Care (Direct Payments) Act 1996 does not apply in relation to payments under subsection (1) to—
(a) a person with parental responsibility for a disabled child, other than a parent of such a child under the age of sixteen, in respect of a service which would otherwise have been provided for the child; or
(b) any person who is in receipt of income support, working families' tax credit or disabled person's tax credit under Part VII of the Social Security Contributions and Benefits Act 1992 or of an income-based jobseeker's allowance,
and in those cases the amount of any payment under subsection (1) is to be at a rate equal to the local authority's estimate of the reasonable cost of securing the provision of the service concerned.'.

No. 44, in page 4, line 24, leave out "parent of' and insert—

'person with parental responsibility for'.

No. 45, in page 4, line 26, leave out "parent" and insert "person with parental responsibility".

No. 46, in page 4, line 27, leave out first "parent" and insert "person with parental responsibility".

No. 47, in page 4, line 27, leave out "the parent may" and insert "that person may".— [Mr. Hutton.]

Clause 7

Charging

I beg to move amendment No. 27, in page 4, line 45, leave out clause 7.

This is a probing amendment; I do not necessarily want clause 7 to be removed from the Bill. However, the amendment provides the opportunity to discuss charging. I raised the matter initially on Second Reading when I referred to the briefing that I received from the London borough of Barnet, where my constituency is situated. The briefing outlined Barnet's policy on charging and the anxieties that had been expressed to it on the matter. In an intervention on my speech on Second Reading, the right hon. Member for Bromley and Chislehurst (Mr. Forth) referred to the vague explanatory notes, which did not provide much information on charging. He suggested incorporating the word "reasonable". That was a good idea.

Perhaps the best starting point is the view of Carers National Association on charging. It believes that carers should not have to pay for the services that they will receive under the Bill. On a point of principle, it opposes charging for non-residential community care services because carers already devote their time, energy and money to caring. The organisation asks why carers should pay for a service that helps them to continue to do that, especially when many families experience financial hardship and many disabled people refuse services because they cannot pay for them. It points out that carers save local authorities and the public purse money through the unpaid services that they provide for members of their families.

The Carers National Association also refers to the complications that arise from clause 2, which defines the services that are to be provided for carers. I mentioned that earlier in the context of transport to day centres and the risk of carers being charged for a service that is provided to the person who is being cared for. That matter should be tackled. There was no opportunity to do that earlier because of the way in which the debate unfolded. Perhaps those who reply to the debate could deal with the anxieties that the Carers National Association raised.

On Second Reading, my hon. Friend the Minister suggested that it was right that carers should be charged for services. I have dealt with that point in principle. I understand my hon. Friend's point, and that of the London borough of Barnet. Its briefing states that if it did not charge a reasonable amount for at least some services, they might not be provided. However, this brief debate gives the Government an opportunity to go a little further.

On Second Reading, my hon. Friend the Minister said that users and carers would be fully involved in consultation on the charging regime. Perhaps he will clarify the operation of clause 7, and tell us the extent to which charging for council services will be considered as part of the overall review of charging for services for carers and those who are cared for.

As my hon. Friend the Member for Hendon (Mr. Dismore) says, the amendment would prevent carers from being charged for carer services. As my hon. Friend will know from our earlier exchanges, a private Member's Bill is not a vehicle for change in Government policy on charging; nor, I suggest, is this a time when charges are under consideration in Government. I therefore ask my hon. Friend to withdraw the amendment.

I also invite my hon. Friend the Minister, who I know wishes to speak, to repeat his commitment on Second Reading—which has already been mentioned—that the Government will ensure that representatives of carers organisations will be involved in the forthcoming consultation on charging, which will follow the publication of the Audit commission's study of non-residential charges. I am sure the Minister will expand on that, either now or on Third Reading.

As my hon. Friend the Member for Hendon probably knows, this was the one real problem I encountered in promoting the Bill, but the Minister has assured me that the Government will take the issue seriously, and consider it sympathetically.

I was involved in neither Second Reading nor the Committee stage, but most of us who have spent any time in the House know that carers can lose a substantial amount over what we would term a potential working life, in terms not only of earnings but of retirement pension. Many carers have given up the opportunity of paid work or leisure time. Indeed, they save huge sums for local authorities and, sometimes, for central Government, via health authorities. Regardless of what my hon. Friend the Minister feels, and regardless of what past Ministers have felt, carers feel that they should not have to pay for these services.

I have received a certain amount of correspondence about the Bill. One of my constituents was unable to take work opportunities because he was looking after both his elderly parents for many years; now he is looking after one of them. He would probably find the idea of being charged for time away from work hard to accept. He wrote to me saying that, owing to restrictions on the type of work that he has been able to do, he will not benefit from, for instance, the retirement pension from which many of us benefit. We should consider the level of any charges that are made.

I am sure that my hon. Friend has noted what the Carers National Association has said in the past. The association now wants to know the likely level of charges, and also wants an update on the extent to which charging carers for services will be considered in the review of charging. We discussed earlier what would effectively be means-testing for the purposes of all charges. I do not think that my hon. Friend or anyone else is in favour of that, but it is important to know whether carers will be able to afford charges for respite care. Over the years, I have encountered many constituents who might not have taken the opportunity of respite care if charges had been made, because their incomes would have been too low.

1.30 pm

Carers can be in need of care themselves. Although the amendment is only a probing amendment, it addresses important issues. We hope that the Bill will achieve the practical reality that it promises, by bringing help and assistance to people who, by caring, do much good work for their direct families—and indirect families, in some cases—and for taxpayers, by saving massive amounts of money on institutional care. My hon. Friend the Minister will recognise that and I hope that any proposal to levy charges in the future will recognise how much good work carers do. They need the respite care and should not be discouraged from taking advantage of it by overcharging.

I thank my hon. Friend the Member for Hendon (Mr. Dismore) for tabling amendment No. 27 and giving the House the opportunity to discuss these important issues. The issue of charging has come to light because the Bill will allow local authorities, for the first time, to provide carer services directly to carers. To maintain the existing balance between carers and cared-for people, it is obvious that we need to ensure that the present arrangements apply equally. To do otherwise would be to prefer one group above another. In this context, we would be treating carers more favourably than the cared for, and that would be inequitable and unfair and could not be justified.

Within Government and outside, we are discussing extensively the future policy on charging for non-residential services. To be coherent, that policy needs to be located within the context of the Government's response to the royal commission's proposals on residential care services. We must strike the right balance between residential and non-residential care services. There is a strong groundswell of opinion, which is backed up by much of the constituency experience and case work that we all have, that criticisms can be made of the charging regimes applied by many local authorities. The arrangements are set out in the Health and Social Services and Social Security Adjudications Act 1983, which simply requires local authorities to set charging policies that are reasonable. Under the existing legislation, the Government—in this case, the Department of Health—have limited powers to issue any effective guidance to local authorities about how they exercise the statutory discretion that they have been given to fix local charging arrangements and means tests, whatever policy they decide to adopt. Some eight or nine authorities do not charge for services at all.

The existing arrangements clearly give rise to the scale of variation that we see across the country, and that has fuelled a sense of injustice among many service users. The present arrangements are not working fairly. Why is it that a modest charge is made in one part of the country, but a much higher charge is made for similar services in another area? The Government have made a commitment to address those issues, and we will do so in the context of our response to the royal commission and in the light of the Audit Commission report on the scale of variation between local authority charging regimes.

My hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) was right to say that a private Member's Bill is probably not the appropriate way to deal with the substantial issues of social care policy that have an implication for the taxpayer in terms of the resources available to local authorities.

My hon. Friend the Member for Hendon knows that we are trying to make the Bill cost-neutral. That is entirely appropriate, but I would not want anyone in the House or outside to think that the Government are not addressing the wider issues that he has raised seriously and as a matter of urgency as we develop our response to the royal commission.

Towards the end of 1998, when we published our White Paper on the future of social services, we set out clearly our policy objectives in this area. We want to reduce the unacceptable rate of variation that clearly exists between authorities providing similar services. That does not lead to the national consistency that we are determined to achieve.

We are taking action to ensure proper consistency in standards throughout the national health service. Social care is a crucial partner to the NHS in providing effective support for carers and people who are being cared for. It is one care system that has health and social care as equal partners. As part of the drive for consistency in the NHS, it will obviously be important to address consistency in the standard and quality of social services, which we are taking action to improve, as well as issues relating to the charging regime that local authorities apply.

On this occasion, I did not make the first reference to the royal commission. I welcome the Minister's outlining the initiatives that the Government are taking. In July, we shall learn what they intend to do. Although I entirely understand that the Minister cannot tell us what those proposals will be, can he give us some idea—as many outside the House want to know this—of how quickly the changes will be implemented, as we are already two years away from the White Paper to which he referred and it is more than a year since the royal commission reported? When will the proposals be implemented? Will it be in the lifetime of this Parliament?

The hon. Gentleman is inviting me to make policy announcements, but I am not in a position to do so, so I shall decline that helpful request for what he described as clarification. Let me correct him on one point. The hon. Gentleman said that we were two years away from the White Paper and asked why the Government have waited so long before making our policy intentions clear in respect of reforming the local authority charging arrangements for domiciliary care services. I know that the hon. Gentleman is most diligent, so if he checks the White Paper he will see that, in November 1998, we made it clear that, before we announced any detailed proposals, we would await both the outcome of the royal commission's recommendations and the work of the Audit Commission. The Audit Commission's report has not yet been published and we need some of the data and intelligence that it is likely to contain to help us get some of the detail of the policy right.

Obviously, there is urgency, as I have said, but I hope that hon. Members understand that I am not in a position to announce detailed proposals against a particular time scale. It is not because I do not want to do so; I am simply not in a position to make such announcements. It is as simple as that.

My hon. Friend the Member for Hendon has drawn attention to a wide-ranging area of concern that has come to light in the context of the Bill because, for the first time, we are allowing local authorities to provide services directly to carers. Obviously, the issues in clause 7 have been brought into focus. For reasons that my hon. Friend has made clear, we need clause 7 in order to maintain the equity and balance between carers and those being cared for, when it comes to charging for non-residential services. To do otherwise would be to disadvantage disabled people. That would not be fair or equitable, and I am sure that no one in the House would countenance any such course of action.

In essence, I am asking the House to bear with us until we can announce more detailed proposals for reforming the local authority charging arrangements. As my hon. Friend knows, we are committed to looking at that and to making sure that carers organisations and others have the opportunity to be fully involved in the work that we shall announce in the summer on making the system fairer and reducing the current scale of variation in local authority charging arrangements. That is no secret. We have always been very open about our intentions in those regards.

I am grateful to my hon. Friend for providing the opportunity for this debate. For reasons that he has made clear, we cannot accept the amendment, and I hope that, in the spirit of what he said earlier, when he described it as providing an opportunity for debate, he will not press it to a vote.

In view of what my hon. Friend the Minister has said, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 10

Interpretation And Regulations

Amendment made: No. 35, in page 5, line 20, after "(1)", insert—

'Except as provided in section (Assessments: parents of disabled children)(6),'.—[Mr. Pendry.]

Clause 11

Short Title, Commencement And Extent

I beg to move amendment No. 28, in page 5, line 41, leave out subsections (2) to (6).

This is a relatively short probing amendment, which would delete the Bill's provisions dealing with its commencement and extent. I have tabled the amendment to put my hon. Friend the Minister on the spot and to give him the opportunity to tell the House when the Government want the Bill to come into effect.

The amendment would cause the Bill to come into effect as an Act on the day on which it received Royal Assent. In general, the normal convention is that no Act or part of an Act should come into force earlier than two months after Royal Assent has been granted. It is desirable that at least a reasonable period should be allowed, and in this case time will be needed for consultation with interested parties on the content of policy, the guidance for local councils and the content of regulations. For that reason, the Bill, when enacted, should be brought into force by the commencement order.

Clause 11(5) provides that the Secretary of State may make an order extending the application of the Act to the Scilly Isles, if there are good reasons for so doing. Such an order would be subject to the negative procedure.

I hope that my hon. Friend the Member for Hendon (Mr. Dismore) will agree that the commencement and extent provisions are an integral part of the Bill, and that he will therefore withdraw the amendment.

When he moved the amendment, my hon. Friend the Member for Hendon (Mr. Dismore) asked me to indicate how soon the Bill might be brought into effect after receiving Royal Assent. I made it clear in Standing Committee that the Government want the legislation to be in operation at the earliest possible opportunity.

The Bill is hugely important. For the first time, it will allow a range of services to be provided directly to carers. It provides and extends choice and opportunities in other areas as well. My hon. Friend the Member for Hendon is anxious to ensure that the Bill comes into effect as soon as possible; the Government are, too. We have not done all the work involved to amuse ourselves—we want to improve the services and support available to carers and to disabled children and their families, and thereby improve people's lives.

The Bill is an important step forward for carers and we do not intend to delay its implementation in any way. It will be introduced as soon as possible, but I hope that my hon. Friend will understand that I am not in a position today to give a precise date. However, I assure him and the House that we will not hang around; we want the legislation in place at the earliest possible opportunity.

I am grateful for that assurance. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Order for Third Reading read.

1.44 pm

I beg to move, That the Bill be now read the Third time.

As the House has heard, the Bill enjoys wide support among individual carers and also the voluntary organisations that want to ensure that the needs of carers, and of parent carers, are properly addressed. I have been extremely encouraged by the cross-party support for the Bill that has been evident throughout our proceedings, and I am grateful for it. I thank hon. Members from all parties who have made positive and constructive contributions and assisted the Bill's passage through the House.

I particularly wish to place on record my gratitude to my hon. Friend the Minister for all his help, not least for helping me today because of my recent illness. My thanks go to Patsy Holland from his Department, who has done sterling work in acquainting me with some of the details of the carers world, and to the Carers National Association and other caring organisations. From my own constituency, Carol Ann Morgan, an expert in children's disability, helped me enormously.

I was very touched by a little book by Leon Simons. For many years he looked after his wife, who had great disabilities. He wrote a book called "For the love of Lily", which I recommend to anyone who cares about these issues.

I also thank my friend of long standing, Lord Morris of Manchester, for his wise counsel. I have known him since the age of 15, when we were in the Labour league of youth. To them, and to many others, I give my thanks.

It is a fact that many of us, at some time in our lives, will care for someone else. We give care willingly, because we love those who are nearest and dearest, but for many that caring role will become a larger part of their lives, taking up more of their time, because someone close becomes ill or disabled. The care provided by the carers with whom the Bill deals is not provided on a formal basis by organised, paid professionals. Informal care delivered by family and close friends is provided unpaid; it draws on feelings of love and duty.

Caring is often very hard work and can be emotionally draining. It takes many forms within many types of relationship. Some caring takes place within families, where parents care for their ill or disabled children. Many such parents have provided full-time care since the birth of their child or shortly after, and expect the need for care to be lifelong. Parents may have been thrown unexpectedly into a caring relationship at the birth of their child. Today, with advances in medical treatment and health care, together with pre-natal screening, more parents are forewarned. However, being forewarned does not necessarily prepare parents for how their lives will change.

The onset of illness or disability can be sudden or gradual—sometimes there are elements of both. For example, multiple sclerosis can involve the gradual erosion of ability and a sudden loss of mobility. Parents of children with conditions such as schizophrenia may find themselves learning to cope with very violent behaviour.

Another type of care within families is that which one partner in a relationship gives to another. The circumstances that create the need for care can affect couples at different stages of their lives. In middle life, one partner may be diagnosed with arthritis, a condition that causes severe pain. As the condition deteriorates, more and more care becomes necessary. For some couples, one partner has, over time, become the full-time carer of the other. A stroke in later life can affect eyesight, leaving the stroke victim no longer able to read or complete forms and pay bills. Mobility may be seriously affected following a stroke, as may short-term memory.

Along with many of my hon. Friends, I am aware, from talking to my constituents in my surgeries, of the manifold problems that carers face. They often struggle to continue in their caring role and want help in maintaining their valuable contribution to the care of a loved one. Although the circumstances that lead people to become carers may be different, many of the difficulties faced by carers are common across their situations. The impact of caring on their lives can be similar, including the distress of seeing a loved one in pain, the emotional loss as the nature of the relationship changes, the effect of the caring relationship on other relationships, a sense of isolation and loneliness, and feelings of stress or depression.

I make no apologies for spelling out those examples. I am sure that many hon. Members could give examples of their own. I hope that the examples illustrate the importance of the Bill reaching the statute book. Recent years have seen a growing recognition of the importance of informal care and the effects on carers. In 1995, the Under-Secretary of State for Education and Employment, my hon. Friend the Member for Croydon, North (Mr. Wicks), who was here at the beginning of the debate, introduced the Carers (Recognition and Services) Bill. In 1998, the Prime Minister announced a Government-wide review of measures to help carers as part of a national strategy for carers. That strategy brings together a range of initiatives designed to address carers concerns and give them support.

The Bill is an attempt to change the law so that social services departments may, for the first time, offer support to carers and parent carers. That support will help carers to continue to care, and will assist carers in such a way that they can be assured that their own health and well-being are considered.

Clause 1 provides that a carer or parent carer has the right to ask for an assessment from a local council of his or her ability to provide, and to continue to provide, care for the cared-for person if he or she intends to provide substantial and regular care. The assessment will enable the local council to decide whether to provide services to the carer under clause 2 or the parent carer under the Children Act 1989. This is an important change to the way in which social services departments may provide support. The Bill focuses on enabling carers without detriment to their own health or well-being. There will be services which, although provided by the carer, may be delivered to the cared-for person by way of community care services.

For reasons that have already been outlined, I do not intend to speak for much longer. The Bill is extremely important. I sincerely hope that, having heard the debate today and in Committee, hon. Members will recognise that caring organisations and carers themselves look to us to ensure that it is carried.

1.51 pm

I shall be brief. I congratulate my hon. Friend the Member on Stalybridge and Hyde (Mr. Pendry) for all his work on the Bill. It has received all-party support and there has not been a Division throughout its progress.

The Bill is historic, redressing the balance by which the vast army of carers—thousands in every constituency—provide informal care for those whom they love. Often, even in our welfare state, that care has been provided without recognition, largely by women. It was regarded as part of the contractual duties of marriage, and married women and mothers provided care for disabled children, husbands, mothers, fathers or elderly relatives.

The Bill is important. My hon. Friend referred to the work of Lord Morris, who introduced the charter for the disabled, the Chronically Sick and Disabled Persons Act 1972. The work of carers was not truly recognised until the 1970s. Once, at a conference, Professor Peter Townsend was told, "What you mean by care is care by women." Recognition has been slow of the incredible amount of care provided informally and sometimes at enormous cost. The Government, to their credit, have introduced the national carers strategy, in which the Prime Minister recognised his personal debt to carers in his own family. He also invited representatives of carers organisations to Downing street when he first came to office.

It has been a privilege to be associated with the passage of this important Bill. Some 10,000 carers in my constituency will be pleased that it has been passed, and I am grateful to my hon. Friend the Member for Stalybridge and Hyde and everyone who has supported it.

1.54 pm

I, too, congratulate my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) on successfully steering the Bill through its First and Second Readings, Committee Report and stages and now Third Reading. I welcome the amendments made today; they will help to clarify the Bill. We have had good discussions across the parties, which have produced unanimity. The amendments bring not only greater clarity but more consistency to legislation for carers. That is especially important.

The new clauses are significant; they put more decision making into the hands of carers. That, too, is of great importance. The amendment to clause 2 on agreement between the disabled person and the carer on service delivery decisions is especially relevant to the disabled person or the carer to whom the service is provided. It means that users will be able to shape their own lives. That is very much in the spirit of the report by Sir Roy Griffiths about a decade ago, in which he said that users should have that ability. He said that community care could not be properly achieved until carers were fully recognised and supported. The Bill, as amended, takes us closer to that aspiration.

I hope that my views will be shared by the many millions of carers and the representatives of carers organisations throughout the country. The Bill develops the aspirations of the national strategy for carers, which focuses on producing wider and better sources of information on the help and services available to carers.

Those of us who have been and are involved with carers—either professionally or as constituency Members—must never assume that carers know about the help and services available to them. Sadly, despite all the best efforts of many of the campaigning carers organisations, that is not the case. On a recent train journey, I met a friend—a former colleague who had retired. She had been the head of a sixth-form college and I assumed that she was enjoying her retirement. On that Monday, when she told me that she was looking forward to her day out, I am afraid that I assumed that it was only one of many days out that she was able to enjoy. However, during our conversation I discovered that it was a very special day for her—it was the first in 20 months that she had had any respite from caring for her husband, who had been a university lecturer but had been diagnosed with Alzheimer's disease.

One might have expected that my friend would have known of the existence of the services and support available to carers—or at least have known where to find that information. She is an extremely intelligent woman, who is well informed on many subjects, but she said, "I have to admit I did not know where to go." Sadly, her GP was not helpful and had neither given her information nor opened gateways for her to obtain it. Since her husband's diagnosis, she had coped for 24 hours a day—for nearly 20 months. They had looked forward to a pleasant retirement, but instead she had been under a tremendous strain during that time. She said that it was almost unbelievable when, by accident, she heard a radio programme that mentioned respite care.

Suddenly, my friend realised that there was a chink of light at the end of the tunnel. With great tenacity, she asked questions—perhaps becoming in the eyes of some professionals a bit of a nuisance—and pursued information about which services were available. Hence, she was delighted when, ultimately, some seven months later, she achieved her goal of one day out a week—one day's break, one day's rest from the strain and emotional and physical difficulty of caring for her husband.

I quote that example as just one of many. Many of my hon. Friends would be able to give others. The Carers National Association and other organisations that support carers will repeat that story over and again. I say that not in any way to denigrate their work, but to prove how difficult it is for carers to recognise what they are doing and then to obtain information from which they may access the support and services that they require.

Support for carers must come from the communities in which they live. Local authorities have that responsibility, and voluntary organisations have the responsibility to assist in that and to provide the support. The carers strategy talks of independence, partnership and empowering carers so that they may make choices about their lives. Those words have been echoed around this Chamber on numerous occasions today.

We are talking about carers being able to maintain their health and exercise their independence, so that their role can be recognised by policy makers and statutory service providers. Giving strong support to carers over service planning and provision will help to ensure that they become partners in the statutory provision of care. The Bill will contribute to all that.

I should like to mention briefly two groups of carers in particular who I think will benefit from the Bill. Working carers will certainly do so. From guidance on the Bill, carers could be given much vital flexibility that they and their families need either to take up part-time or even full-time work. So many people have given up work to care—perhaps as many as 50 per cent. of carers at the heavy end of caring. Many regret having done so; even if it is not possible to return to work, the Bill will give them far more options.

I am particularly pleased with the Government's amendments on the position of parent carers. The impact on parents with disabled children, certainly of direct payments and of the entitlement to an assessment in their own right, will be particularly welcome. With direct payments, they will be able to decide what is best for their child, as every parent wishes. They will be able to engage one person who is trusted and known to provide a range of support for the child. It is of course easier for a child to build a relationship with one person.

Parent carers of disabled children want the flexibility to ensure that the services that they require are provided at their convenience, rather than that of the service provider. Direct payments for parent carers will enable them to arrange their services, fitting them around their family's life style. As the young person grows up, such payments will provide extra support so that, with help, the child can join in mainstream activities with other children. It makes much more sense.

Disabled people have called for direct payments for years. They have largely welcomed their introduction and called for their extension. I am delighted that the Bill extends the principle yet further to parents of disabled children and other carers. That will hugely benefit disabled people aged 16 and 17—again, I have a word of caution—as long as the right safeguards are introduced, as the Minister said in Committee he intended to do through guidance.

The Bill, as amended, will certainly present a new challenge to many, and that challenge is implementation. The Bill has still to pass through all its stages but, as we discuss the Bill, we must think about how it will be implemented. I am delighted that my hon. Friend the Minister is keen to provide more information for carers about their rights—a commitment given in Committee. That is exactly what is needed and should have been provided when the Carers (Recognition and Services) Act 1995 was introduced. We now have the benefit of experience and can do things differently as they move into line with the spirit of the Bill.

As we have said, carers needs are diverse. As individuals, they have their own particular needs and their own reasons for providing care or ending the caring role. However, they have a number of common factors. The first is always concern for the well-being of the person for whom they care. They also need emotional support and relief from isolation for themselves. The receipt of reliable and satisfactory services and information on, and recognition of, their role and contribution can all work well in supporting carers.

Let us stop for a minute and consider the definition of the word "support". It has been used a great deal in the debate. I looked in the dictionary and found three definitions of the word. First, it means to carry all or part of the weight and to keep from falling, sinking or failing. Secondly, it means to provide with a home and the necessities of life, and thirdly, it means to enable, to last out, to give strength or to encourage. I sincerely hope that, in our deliberations on the Bill, we have gone some way towards giving carers real support, building on the Carers (Recognition and Services) Act 1995 and taking it forward.

2.7 pm

I shall endeavour to make my contribution short because I know that several Members would like the opportunity to give the Bill their blessing and send it on its way. However, I understand that the hon. Member for Halesowen and Rowley Regis (Mrs. Heal) has a declared interest, having worked for the Carers National Association. We understand that when this issue is a core interest, one will have strong feelings about the Bill making progress.

May I congratulate, once again, the hon. Member for Stalybridge and Hyde (Mr. Pendry)? He definitely backed a winner with this Bill. Certainly, having the Government on one's side is a tremendous help in succeeding with a private Member's Bill. In my three years in Parliament, it is the first time that I have seen such a Bill reach this stage. I congratulate the hon. Gentleman on that.

We can all take satisfaction from knowing that today we shall send a strong signal to the 5.7 million carers in our society who for a long time, out of good will, have made a contribution that is worth £34 billion of care. That is a phenomenal contribution towards care for those who need it. We can all take pleasure from the fact that the Bill has progressed to this stage, and that is why we have supported it. We very much wanted to send a signal to carers that we applaud what they do and that we want them to continue to do it. That is important for those for whom they care, for themselves and for us. We all have an interest in sustaining them in their very important role.

The little phrase that comes to mind is "a stitch in time saves nine". As a result of the Bill, we all hope that respite will come to those who might be on the verge of throwing in the towel, having a breakdown or giving up their key role. I hope that we have contributed to that stitch in time, which for some people will be so important.

I very much liked the modesty of the hon. Member for Stalybridge and Hyde. He said that the Bill was a start. I am always wary of politicians who claim too much for what their policies will achieve, so he is right to be cautiously modest. Perhaps, we can all share in that.

The assessment process, how it works in practice and the experience of the carers who are on the receiving end of it will be crucial. Whether what they are assessed as needing is delivered will be the test by which we shall know whether we have succeeded or failed collectively as a group of politicians.

In recent days I have encountered people who strongly dislike the style of politics in which we all gratuitously make remarks about each other. However, we can all agree that the discussions today, the Committee proceedings on the Bill and its Second Reading have been, for those who have been able to watch, an example of what can happen when there is constructive opposition in the House and we work together. As an Opposition, we have combined with other hon. Members to refine and improve the Bill, and we take satisfaction from that.

We hope that the Bill will see the light of day as soon as the Government can find time for it. The real test will be whether those who are directly concerned—carers and the cared for—experience an appreciable improvement in their situation and whether carers receive the help that they need to carry out their important task.

2.10 pm

As the hon. Member for Meriden (Mrs. Spelman) said, the test of the Bill will be the services that result from the assessments that will be provided.

I congratulate the hon. Member for Stalybridge and Hyde (Mr. Pendry) on his initiative in securing a private Member's Bill slot, on choosing this important subject and on skilfully piloting the Bill through all its stages in the House. This is the first private Member's Bill that I have followed through all its stages, and it has been an interesting experience that is very different from my experience of Government legislation. I hasten to add that I do not intend that to be a criticism.

We have had the opportunity to debate the Bill on the Floor of the House. Amendments have been moved, ideas discussed and concerns explored, and there has been a genuine response that has led to the Bill's improvement. The result is a Bill that we can pass to the other place and which will, we hope, make its way into statute and make a real difference to the lives of millions of carers.

I know that the Bill will make a difference to the 20,000 carers in my constituency. When I spoke on Second Reading, I explained that I had spent a day with a carer in my constituency during national carers week last year. Her name is Lillian, and she felt very isolated because of her caring responsibilities, looking after her husband. She felt that she had had to struggle to navigate her way through the various services that were available, and she was not told that those services existed to give her support.

This is a Bill for the millions of Lillians who give years of their life out of love for their partners and others in their family, to support them, informally, in the community. Through the Bill, the House signals that it wants to support those carers and values them highly.

Liberal Democrat Members support the Bill because we believe that it is a much-needed addition to the legislative framework governing carers. The Government amendments in response to debates in Committee are welcome and have improved the Bill. They send the right signals to carers that the Government are committed not to introducing charges by stealth but to improving services for carers.

2.13 pm

Before I comment on the Bill and the proceedings today, in Committee and on Second Reading, I must go through one or two necessary and important formalities. In the Government's view, the Bill is fully compatible with the European convention on human rights.

I echo many of the comments of hon. Members. The Bill has benefited from the cumulative experience of the many hon. Members who know a great deal about its subject matter. It is probably unfair to pick on individual Members who have made important contributions, because we have been lucky to have had the commitment of many hon. Members, in Committee and today, in improving the Bill. However, I pay particular tribute to my hon. Friend the Member for Halesowen and Rowley Regis (Mrs. Heal). She has been heavily involved in carers' issues for a long time, and we have been fortunate to have the benefit of her experience and opinion.

Most important, we have been lucky to have the support of my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry). Without his commitment to the cause and without his dedication to working with all Members to improve the Bill, we would not be in the position that we are in today, so I pay a warm and personal tribute to him for his work and vision in taking the Bill forward.

As the hon. Member for Meriden (Mrs. Spelman) said, sometimes we actually get it right in this place. I will not say that we do it all the time—clearly, we do not—but during the passage of the Bill, we have shown that it is possible in the House of Commons to work together on common objectives that transcend party allegiances and that inspire and motivate many Members. In fact, they may often explain why Members are driven to serve as Members of Parliament.

Many of us have a strong and deep commitment to improving not only public services, but the quality of life of many people in our society who, without our commitment and support, will never get the quality of life that we are fortunate enough to take for granted. That is what the Bill is basically about. It is ultimately about creating a fairer society. It is about providing better services for carers and disabled children, too, but it is profound legislation. I will not make the mistake of using hyperbole, but it is an important Bill.

There are several reasons why the Bill should receive a Third Reading. First, it will enable local authorities to provide a much wider range of services directly to carers themselves. That is something that carer organisations have long called for, as my hon. Friend has said. The Bill will ensure that that can happen, ending the unacceptable limitation on local authorities' ability to support carers properly.

It is clear from some of the discussions today that, in moving forward in that area, we must be alert to the sensitivities that exist. It is not part of the Bill—my hon. Friend has been clear about it, as has everyone else who has spoken today—to do anything to compromise the position either of carers themselves or of those who are being cared for. I believe that the way in which we have improved the Bill today will mean our avoiding that particular mistake.

Secondly, the Bill takes a further important step forward in recognising the role of carers as key partners in improving services to people who need support at home. Fortunately, the days are long gone when carers were the invisible people whose contribution usually went unacknowledged and whose own needs for support were rarely, if ever, addressed effectively. The Bill represents a significant advance for carers in both those important areas and is therefore a significant advance for carers as well as for the whole care system.

My hon. Friend the Member for Monmouth (Mr. Edwards), who spoke very well on Second Reading and again on Third Reading, is right to have identified what has been characterised as an enormous gap in social care policy in Britain for many years, which we are now beginning to close, properly recognising the role of carers. He explained that much more eloquently than I could, but I hope that he will share my view that the Bill is a significant advance, as I have shown, because it plugs that gap. Carers are not invisible. They are crucial partners in care, and the Bill acknowledges their important role.

My hon. Friend mentioned his constituency and the carers in Monmouth who will benefit from the Bill. He gave a timely reminder that the Bill will apply to Wales, too; it is not an England-only measure.

Thirdly, the Bill extends new opportunities for carers and disabled people to have more direct control over the services that they need. Its changes to the 1996 direct payments legislation will transfer more power and more choice to carers and to disabled children to determine for themselves who may provide the services that they have been assessed as needing and when they should be provided. In that way, the Bill will enable and empower disabled people and their carers in a significant new way.

Most important, my hon. Friend the Member for Stalybridge and Hyde has listened to the concerns that have been expressed by carers organisations about his Bill's drafting. Today, he has introduced some very important changes to the Bill that strengthen it considerably. Parent carers' right under the Bill to ask for an assessment has been put beyond any doubt. We have also resolved the concerns that have been expressed about the nature of charging for both carer services and community care services. Now, there can be no risk at all that local authorities can label services as carer services rather than as community care services if it appears that the carer has greater means than the cared-for person.

The Bill also provides that carers cannot be required to pay a charge for community care services that are provided to the cared-for person. It is a significant clarification and confirmation of the original intentions that both my hon. Friend and I had for the Bill. I pay tribute to him for his ability to argue that case and to press for the necessary changes to the Bill. He was absolutely right to identify that as an important issue, and I am grateful to him for his role in making the necessary changes to the legislation.

I know that all hon. Members value the contribution that carers can make to our community and to our country. Today, hon. Members can show their support for carers by giving the Bill the strongest possible support.

I should like to conclude by expressing once again my appreciation to my hon. Friend the Member for Stalybridge and Hyde. By promoting his Bill, he has performed a huge service for carers, for disabled children and their families and for those who are being cared for. We are doing a good thing by sending the Bill to another place, where their lordships will have an opportunity to contribute their wisdom and insight to the legislation. Some of those who are in another place have enormous experience on the issue.

On Report and in this debate, we have not really focused on the special problems faced by ethnic minority carers. Perhaps my hon. Friend would like to say something about the Bill's impact on them. I think that it is important that we address that issue.

I am grateful to my hon. Friend for raising that issue. He will know, because he has examined the Bill very carefully, that nothing in the Bill deals directly with the needs of carers from ethnic minorities. However, that is not to say that the Government do not recognise the need for additional work on that issue. Since we came to office, we have taken various initiatives to work with ethnic communities in finding ways of improving access to social services.

As I am sure my hon. Friend will be aware, there is plenty of evidence that members of ethnic minority communities do not feel that they have proper access to or receive the proper support from social services that they are entitled to expect. There may be many good reasons why social services are provided as they are, but that does not obviate the need for improvements in provision. It is not acceptable for any section of our community to feel marginalised or disfranchised by the failure of statutory services properly to recognise their needs. We shall have to continue working and acting with local authorities on the issue, to ensure that services fully meet the needs of all sections of our community.

My hon. Friend mentioned the Bill's progress in another place and the timetable for its implementation, which were also mentioned earlier. Although it is not a Government Bill, does he have any idea about the other place's likely attitude to it? Today and in our previous consideration, the Bill has received overwhelming support from hon. Members on both sides of the House. Have discussions been held with the other place to discover whether it is likely to receive the same all-party support there, so that it can be implemented as soon as possible?

I very much hope that that it will receive such support. There is no doubt that some of those in another place have enormous practical experience of many of the issues addressed in the Bill. Baroness Pitkeathley, for example, is a very experienced Member of the other place and has huge expertise on the issue; I am sure that she will bring those qualities to bear in ensuring that the Bill is passed. Knowing how careful their lordships are, I am also convinced that they will study our debates closely, because, as the hon. Member for Sutton and Cheam (Mr. Burstow) rightly pointed out, the Bill has been significantly improved by the willingness of my hon. Friend the Member for Stalybridge and Hyde to listen to the concerns that were expressed about it and to take action on them. As a result, we have a better Bill that, I hope, will command the support of their lordships and people outside the House.

We have taken the unique opportunity provided by my hon. Friend to produce legislation that can command a consensus of support in the country. We have laid the foundations for legislation that will continue to inform and support service development for many years. Sadly, we do not often have an opportunity to legislate on these issues. The changes that have been made have resulted in a significantly better Bill.

My hon. Friend has mentioned that the Bill applies to Wales as well. I am sure that he will join me in paying tribute to the National Assembly for Wales for the support that it has given to the Bill in principle. Does he agree that one of the aims of the Bill is to equalise the best in services for carers? There is considerable variation between local authorities in England and Wales. That principle of equalising the best has always applied in the national health service, although it has not always necessarily been implemented. We need to apply that commitment to social care as well as to health care.

I do not think that my hon. Friend will be surprised that I strongly agree with him. Through the introduction of the new performance management arrangements for local authority social services and through the new best value powers, we are trying to ensure that the standards of the best local authority providers become the standards for the rest. We aim to ensure that the performance of the top 25 per cent. of local authorities becomes the benchmark for others to follow. There is a lot of work to be done to ensure that, not only on the provision of carers services. We must stay focused on all the issues.

My hon. Friend will be aware that the implementation of the legislation in Wales will be a matter for the National Assembly for Wales. We look forward to talking with Assembly Members about our plans for implementation.

We still have to work out some of the details of the regulations and the guidance and advice that will be given to local authorities on some of the important issues that we have discussed today. I have repeatedly tried to assure hon. Members that we shall develop the new regulations and guidance quickly, effectively and in a process of open consultation with all the interested organisations. We have nothing to hide from them and everything to discuss with them. That is the spirit in which we intend to take the legislation forward over the next few months.

We want to proceed as quickly as we can and put the Bill on the statute book at the earliest opportunity. If we succeed, we shall have done everything that hon. Members want—provided pioneering legislation and delivered it as quickly as possible so that the service changes that we all want come about soon on the front line. Carers, their families and disabled children will be able to see the immediate impact of what we have done.

I have spoken for long enough. I urge the House to give the Bill a Third Reading.

Question put and agreed to.

Bill accordingly read the Third time, and passed.

Remaining Private Members' Bills

Recycled Content Of Newsprint Bill

Order for consideration read.

Object.

To be considered on Friday 12 May.

Medical Treatment (Prevention Ofeuthanasia) Bill

Order read for resuming adjourned debate on Question [14 April] on consideration of Bill, as amended in the Standing Committee.

A new clause—Consent of the Director of Public Prosecution—

"No prosecution under this Act shall be brought without the prior consent of the Director of Public Prosecutions"—[Mr. Forth.]

Question again proposed, That the clause be read a Second time.

Object.

Debate to be resumed on Friday 12 May.